HomeMy Public PortalAbout6140-6142 OAK AVE_Sewer__ ' COUNTY OF IAS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0705170001
BIIILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
(LEGAL ID: (SEWER / SEPTIC: SEWER I BIIILDING ADDRESS: 1
ON FILE (EXIST OCC GRP: 6140 OAK AV
1BLDGS. NOW ON LOT: I TEMP CA 917801653 1
(ASSESSOR INFORMATION NUMBER: (CONNECTION TYPE: I NEAREST CROSS STREET: 1
15385-010-011 (ORIGINATION: I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl
I ILENGTH ML TO PL: STATION: DEPTH: 1 I
1TENANT: MANHOLE REFERENCE: UPPER/LOWER: 11SSUED ON: PROCESSED BY: EXPIRES ON: 1
1 I 105/17/07 SR 11/13/07 ]
ICOUNTY IMPROVEMENT NUMBER: I I
10WNER: TEL. N0: 1PLAN CHECK NUMBER: 1FINAL A FI Y: CODE: 1
1SERRANO JOAQUIN;JUANA D (626) 287-7256- 1J0B NUMBER: 1 �j I
16140 OAK AVE 1TRUNK PERMIT NUMBER: I� I
1TEMPLE CITY CA 91780 1R0AD PERMIT NUMBER: IDESCRIPTIdN OF WORK 1
I IAFFADAVIT: NO 1CONNECT HOUSE SEWER 1
I IWAIVER: NO I I
1APPLICANT: TEL. NO: (EASEMENT: NO I I
1KEN FANGT (909) 569-2069- I 1 1
124321 CLAYWOOD DR. IRECORD INSTRUMENT NBR: RECORD DATE: 1SPECIAL CONDITIONS: 1
DIAMOND BAR CA 91765 (HIGHWAY/STREET WIDENING: 1
]STATE ENCROACHMENT PERMIT NUMBER: I 1
1C0NTRACT0R: TEL. NO: I FEES PAID (APPROVALS DATE INSPECTOR SIGNATURE 1
1SERRANO JOAQUIN (626) 287-7256- 1 I I
16140 OAK AVENUE LIC. NO 1FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:INEW HOUSE SEWER I I I
1TEMPLE CITY, CA 91780 NONE I I1 I
I 101 PERMIT ISSUANCE FEE 27.75 1CONNECT ADDITIONAL I I I
I - 119 CONN ADDTNL BLDG(S) 1.00 EAC 30.45 1BIIILDING OR WORK I I I
1ARCHITECT OR ENGINEER: TEL. NO: 1 TOTAL FEES 58.20 1 1 I 1
I - I ISEPTIC TANK, SEEPAGE PITI I I
1 LIC. NO: 1 (AND/OR DRAIN FIELD I I I
I I 1DRYWELL
I I I I i I
1 SEWER MAP BOOK: PAGE: ] 1ALTER, REPAIR, SEWER OR 1 1
I I 1SEWAGE DISPOSAL SYSTEM 1 1
I 1 (DISCONNECT PLUG AND I I I
I I 1ABANDON HOUSE SEWER I I 1
I I 1BACKFILL SEPTIC TANKS
I I 1SEEP. PIT _ CESSPOOL
IGRAYWATER SYSTEM
I I I I I I
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REPORT ID: DPR266 ROUTE TO BS0508
I II ] 1 1
I I I
CES08A 4/72
76AC42;- APPLICR410N FC4 PERMIT
COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILOING
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PERMIT NO-
INDUSTRIAL
WASTE.APPROVAL
OWNER'S PERMIT
I CONNECTION CHARGE FEE
AUTHORIZATION TOTAL FEE 4_2 �E
REIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON,
T ACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
APPROVALS DATE 'INSPECTOR'S SIGNATURE
TRACTOR THE PUBLIC. S
SIGNED THIS DAY 0 19 ------
'D F-71,211?I ���_ --
OWNER OR f w NEW HOUSE SEWER
CONNECT ADDITIONAL
OWNERS AGEI`j+���ll OR-CR.
SEPTIC TANK.SEEP,PIT(S)
IHERESY ACKNOWLEOGE THAT I HAVE. READ TH17jr-AfLIlATI.N AND/OR DRAINF�ELD
ANG STATE THAT THE ABOVE 19, CORRECT AND AGREE TO COMPLY
WITH
A ALL. COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMB NG
SEW r RS. - DRYWIELL
4 G AND CESSPOOL L
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR
LACENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSALS
YSTEM
�DFOR'N IA THE
-1 AM THE LEGAL OWNER OF, AND INTEND TO ��ONNECT PLUG AND
HE tENTIAL PROPERT�
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OF PFRMTTTEF
SIG BACKFILL Sc,
10 CESSPOOLS
VALIDATION
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