HomeMy Public PortalAbout10104 OLIVE ST_Sewer__ COUNTY OFJOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0006300016
BUILDING ARD SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGA D: SE ER -SEPTIC:-X BUILDING ADDRESS:
TR: 10558 LT: 20 EXIST OCC GRP: 10104 OLIVE ST
SLOGS. NOW ON LOT: TEMP CA 917803344
SSESSOR INFORMATION NUMB R: CONNECTION TYPE: NEAREST CROSS STREET: BALDWIN
8585-002-020 ORIGINATION: THOMAS PAGE: 597 GRID: 84 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED 0PROCESSED BY: EXPIRES ON:
06/30/00 UT 12/27/00
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FIML DATE FINAL BY: CODE:
SHUI MICHAEL (626) 582-8235- JOB NUMBER:
10104 OLIVE ST TRUNK PERMIT NUMBER:
TEMP 917803344 ROAD PERMIT NUMBER: DESCRIPTION OF WORK
AFFADAVIT: NO CONNECT GARAGE TO SEWER
WAIVER: NO
APPLICANT: TEL. 0: EASEMENT: NO
SAME AS OWNER -
RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREELWTD N. NG•
STATE ENC OA C�1 T Pg�I BER•
.�/ 5 Cn\,
CONTRACTOR: TEL. NO: / �5�:,,ppA•ID APPROVALS TE INSPECTOR SIGNATURE
SAME AS OWNER - �O /'��
LIC. NO FSE /DESC ' P ON: QUANTITY: UOM': AMOUNT: HOUSE SEWER
AAQQJ/�ERM; T ISSUAN¢��FE 27.75 CONNECT ADDITIONAL
9 C6NN DDYNL BL G 1.00 EAC 30.45 BUILDING OR WORK
ARCHITECT OR GINEER: TEL. NO: - / / T TAL FEES 58.20
rl/
SEPTIC TANK, S-E-EP-AG-E-P-17 Lo
LIC. NO 1111111 - AND/OR DRAIN FIELD
DRYWELL
SEWER MAP BOOK: PAGE: r,n n D Ty��O ALTER, REPAIR, SEWER OR
1`J U C \J IS-21lu"(� SEWAGE DISPOSAL SYSTEM
DISCONNECT PLUG AND
O l ABANDON HOUSE SEWER
*� 41"
� *,,t AC FILL SEPTIC TANS _
Q ❑ rr, ' SEEP. PIT _ CESSPOOL _
El ��I�`;�c� GRAYWATER SYSTEM-----
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REPORT ID: DPR266 ROUTE TO BS0508
7vAEdAPPLICATION FOR PERMIT1
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5 E-6663]2.54
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles BUILDING
WM. J. FOX. COUNTY NTY ENGINEER AADDRESS -
CASSATT D. GRIFFIN, SUFP•T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST - - —
GAUSS
ST,
LEGAL _
DESCRIPTION _ LOT NO. OWNER
BLOCK TRACT MAIL - --- ��
NO.OF BLw,G
�..
SIZE CF_L_O_T NOW ON LOT CITY 7-tL,.NO.
USE OF -
BUILDINGS DISTRICT NO. GROUP NAP
.__ --- -- :---.— - a---
ex PG
—__.
.CONTRACTOR •� J j! '
ADDRESS CONNECTION DATA -
CITY TEL, NO. STATION a 5 /
DEPTH
Lj TATE -- y MANHOLE REFERENCE
REGISTRATION N0. ,,,.,i -p+' UPPER "C'9iWey;
"- ".-'-'�-".--'_ TYPE OF CONNECTION LENGTH,yFROM y�
No, DESCRIPTION OF WORK FEE �,— am' P.L. 0,L,T�0 P.L. J
Z
HOUSE SEWER CONNECTING To -_�.^ I------- �J --
PUBLIC 5E4ER _ ) $ S.50 ---
I HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
WORK C HO !T SEWER _ 1.00 t --
CONNECT ADD'T(ONPBLDG. CR CO, 1MP. N0. r JOB. NO.
A L7L1 -2 OR RLSA1R LSYS E tv — --
S IFR OR DlSFOSA5YSTE A" 1 UC RU.dK PrRMiT N0. ROAD PERMIT 0.
O
D S NNE AND ABANDON SEWER 'r,.47c EtiCR0RC4ih1ENT
A S' CR DISPOSAL SYGItM — 1 00 __� .-ER MIt NO.
SEPTIC TANK. ScEAAGf".PI'S OR —.__._-..—..._._
PSIS A.fI D/OR URAINE;EL_D__ 2,OC :NDUSTRTAL
CESSPOOL-DRYWL�L - � .j—" WASTE APPROVAL
SPECIAL CONDITIONS ONLY 2.00 I CHARGES -
-- LaEL3L4�LT -"""'----- ---- -- CONNECTION CHARGE FEE
OWNER'S
AUTHORIZATION - TOTAL, FEE---� _ — RFIMBURSEMENT FEE
I HAVE THIS DATE CONTRACTED WITH THF HEREIN NAMED CON- ---APPROVALS
�+
TR'CTGR TO CONNECT THE ABOVE DESCRIBED E-XISIING DWELLING .e'z$"g'1.e.�VALS DATc INSt�:TOtz 5 5'GNAT ur,E
- - -�--.--_ -------_.—�.__..—._----
t0 tl�L`�,. PUBLIC SEWER - -'
NEW HOUSE SEWER
sreN��D TI-IIs_ __DNr o�__________-.—_�__.___�9_.__..
O'NNER OR CONNECT ADDITIONAL _BUILDING OR WORK --
_
COVNERS AGENT_-.__..�-,_., . - .-- _------' -_----- ..-.-
-- SEPTIC:TANK,SEEP, PIT('$)
ADDRESS..
-AND?Q1.1 DRAIFF ELD _
I HEREBY ACKNOWLEDGE ThAT I HAVE READ THIS APPLICATIC.N CESSPOOL 0 DRYWEL,L E7
AND STATE THAT THE ABOVE I$ CORRECT AND AGREE TO COMPLY — - -
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER, REPAIR,SEWER OR --
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM _
1 HERCSY CER";FY THAT I AN PROPERLY REGISTERED AND/OR _'jiSCCNNECT PLUG AND
AS REGUIR.ED BY LOS ANGELES COUNTY AND STATE OF
C.ALIYORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE ABANDON HOUSE SEWER -_. .._...u...�_--
DESCRIBED RESIDENTIAL PROPERTY. - I
- BACKFILL SEPTIC TANKS EJ
SEEP:PITS) {] CESSPOOLS _
SIGNATURE
OF PER MITTEE^..
4
WILLIAM J.FOX,COUNTY ENGINEER VALIDATION
By
DEPUTY DEPUTY
BY BY
DEPUTY d .._ DEPUTY