HomeMy Public PortalAbout10151 OLIVE ST_Sewer__ COUNTY OF LOS'ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0101180005
' BUILDING AMD SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
: - PHONE: (626) 285-0488 EXT:
EG D: SEWER SEPTIC: Y BUILDINGADDRESS:
BK: 33 PG: 86 PC: 4 EXIST OCC GRP: 10151 OLIVE ST
BLDGS. NOW ON LOT: TEMP CA 917803345
ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: BALDWIN
8586-026-030 ORIGINATION: THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: PROCESSED B EXP RES ON:
02/05/01 UT 08/04/01
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE F' BY: CODE:
LIU;FANXIONG (262) 452-9323- JOB NUMBER:
10151 OLIVE ST TRUNK PERMIT NUMBER: -T/q
TEMP 917803345 ROAD PERMIT NUMBER: SCRI IO 0 0
AFFADAVIT: NO CONNECT GUEST HOUSE TO SEWS
WAIVER: NO
APPLICANT: TEL. O: EASEMENT: NO
SAME AS OWNER -
RECORD INSTRUMENT NBR_RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREET WI.D.ENING =1—
STATE ENCROACHMEpT PERMIT;NUMBERe;.
CONTRACTOR: TEL. NO: EES•.PA•I.D APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO F.EE.DESGRIPTION: r+ QUANT ITY:\UOM:,;y+ AMOUNT: NEW HOUSE SEWER
61 PERMIT I•SSUAMCE
FE _._
\f - 27.75 DDITIONAL
49CONN ADDTNL BL'DG(SEAC, 30.40 BUR WORK
58.2ARCHITECT NGI R: T 0: QTAL FEES
2
0 _ i, - I i I -�' '1,� SEPTIC TANK, SEEPAGE PI
LIC. N
�.---- - � AND/OR DRAIN FIELD
DRYWELL
r—
SEWER MAP BOOK: PAGE: R I'�=� r p ^, �l i' ALTER, REPAIR, SEWER OR
L!'il/ � i - L SEWAGE DISPOSAL SYSTEM
ti - -- - -- - -------- - - - ' D I S CON NEC P G A D
,
ABANDON HOUSE SEWER
,, _• �� BACKFILL SEP C ANKS _
SEEP. PIT _ CESSPOOL _
�t,; ,•�.;;4-� i '_ '� /' '/: G AYWATER SYSTEM
REPORT ID: DPR266 ROUTE TO BS0508
'6A 642D -CES08-10-71 APPLICAT1N FOR AERMIT
COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING qq //'� c
ADDRESS 10151, E. Olive St•
LOCALITY I.Lemi. le City
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. Baldwin Ave.
- _�---
LEGAL .+ T� '7�
DESCRIPTION LOT NO. Y � _ __,{ OWNER 1Hob v• H Vernon .{..
MAIL I
BLOCK TRACT � j� ,_3r�'�1 ✓"� 3'.-�'1� ADDRESS _t,O1. L Olive Li.
NO. OF BLDG$.
SIZE OF LOT NOW ON LOT 2 CITYTeM I.P. City TEL. NO.
USE OF *�*�' �g�- r F
GROUP DHAP E S 5 E D BY
BUILDINGS Res.s �i Gar*
CONTRACTOR ,SqUaDeal Sewer vice ,ADDRESS 29� 3 Maxpon Rd, CONNECTION DATA
CITY El Monte TEL. NO. 444-202 STATE LIC:
•.�.-'sF}� � DEPTH
L CENSE NO, 1.28870 GLASS G_12 MANHOLE REFER/ENCE �' t f LOWER
LIC -DESCRIPTION WORK FEE C-42 d - r a `
_ TYPE OF CONNECTION LENGTH FROM c
HOUSE SEWER CONNECTING TO [[''��jj�� Y. CURB l P.1.> M.L.TO P.L.
PUBLIC SEWER $7.00 tJ iJ P.C.NO.
SEPTIC TANK.SEEPAGE PIT OR r. .� JOB NO.
PITS AND/OR DRAINFIELD @ $10.00 CO.IMP.NO.
HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. rL
PRIVATE DISPOSAL SYSTEM $3.00 Cl
q CONNECT ADDITIONAL BLDG.OR i 00 AFFIDAVIT WAIVER EFSE T RECORD,INSTR.NO. DATE
1 WORK TO HOUSE SEWER ,Z $3.00 l/V
OVERFLOW SEEPAGE PIT.DRAINFI D
EXTN..CE5SPOOL.DRYWELL. - 0 $5.00 HWY. OR ST.WIDENING O
ALTER.REPAIR OR ABANDON HOUSE 0
SEWER OR DISPOSAL SYSTEM 0 $3.00 _ STATE ENCROACHMENT W
MANHOLE ® $7 00 PERMIT NO. _ D_
-- - INDUSTRIAL W
WASTE APPROVAL z
CHARGES
OWNER'S PERMIT s a o0
AUTHORIZATION TOTAL FEE ^� CONNECTION CHARGE FEE
10 0
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE
SIGNED THIS DAY OF 19_
OWNER OR NEW HOUSE SEWER ie
OWNERS AGENT - -
CONNECT ADDITIONAL
BUILDING OR WORK
ADDRESS SEPTIC TANK.SEEP.PIT(S)
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING AND SEW£RS. CESSPOOL ❑ DRYWELL ❑
I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR ALTER.REPAIR.SEWER OR
LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM
CALIFORNIA OR THAT I AM THE LEGAL OWNER F, AND INTEND TO DISCONNECT PLUG AND
RESIDE 7N, THE ABOVE'DESCRIBE. RESIDEN TI P,g%OPERTY. ABANDON HOUSE SEWER
SIGNATURE T BACKFILL
OF PERM"TEE C ..J77 ,j <- 11i�' S£f 3.g,-.y...,G_ S=. t•
VALIDATION CK, M.Q. CASH
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