HomeMy Public PortalAbout10212 OLIVE ST_Sewer__ f DIrAxamr OF COu"y ENGDnmm :SEWER-SEWAGE DISPOSAL
C-.D.IVISION OF-R-MMING AND SAFETY PERMIT APPLICATION 9�
s7 COUN KY OF'LOS ANGELES
v J WILLIAM J. FOX, COLINTY,ENOINE6R ..QQ BUILD /ING
,ADD1lESS ( 6�L O
:. _
FOR APPLIC NT TO f4LL .IN —a. LOCALITY toll_c�%�P
BUILDING %� "NEAREST
.AE OF
r ! CROSS ST.
LOCALITY .lam �. DISTRICT N0: SERIAL NO: PERMIT NO.
NEAREST A S
CROSS ST, ./ J —y� l
RECEIVED BY Ready for Inapeotloa DATE ISSUED
OWNER 'J I i J7.d.d.fs - f`Y : fT���•?, !��-/' t„ _
MAIL /� 10.
USEZONE 0 CUPANCY BK MAP '
ADDRESS /�r v
PG
CITY T.ELAO. I � ,0-�
CONTRACTOR C!A.11fOT'111$ sealer iO:I1S iari0o CO.IMP.NM
ADDRESS 1317 .CoZegr.oye Ave. JoB,No.
CITY MAntebP.110 TEL.NOUN10n 7.5048 TRUNK PERMIT 190.
yy❑❑ STATE
REGISTRATION N.o.10.4 45 rSi�l��1NTY•. .ROAD PERMIT NO.
LEGAL -STATE ENCROACHMENT --.,
DESCRIPTION LOT'NO.. PERMIT NO.
BLOCK TRACT'14Y a / INDWASUS APPROVAL
SIZE OF LOT . N0.OF BLDGS.
p NOW ON LOT CHARGES.
USE OF
BUILDING 8{ CONNECTION OHARGE FEE
NO. DESCRIPTION OF WORK FEE `\\
HOUSE SEWER CONNECTING TO REIMBURSEMENT FSE`
PUBLIC:SEW.ER � $ 3.50 RECEIPT'NO. I DA'rrE B_Y
HOUSE SEWER CONNECTING TOf
PRIVATE DISPOSAL SYSTEM 1.1.00 `
CONNECT ADDITIONAL BLDG.OR EXCEPTIO RECORDED
WORKTO HOUSE SEWER 1.00 NO.
ALTER OR REPAIR EXISTING I .DATE� I BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
A'ND/OR.DISPOSAL SYSTEM -1.00 CONS ECTION DATA'
SEPTIC TANK,SEEPAGE.PIT OR . ._
PITS ANp OR DRAINF•IELD 2.00 STATION 1 d DEPTH
CESSPOOL—DRYW.ELL '
SPECIAL CONDITIONS ONLY 2.00 / MAN.yOLE' FERENCE
!O�,.�2• rUPPER lawn
TYPE OF CoNNECTI LENGTH FROM
Yz CU'RB, f P.Li M.L.TO P.L. ..d•�3
OWNERS. PERMIT $J 1 00- -
AUTHORIZATION TOTAL FEE I
I HAVE THIS 'D'ATE CONTRACTED WITH'THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS- INSPECTbWSSIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS..........._.......D 'Y OF .._........_..`...-......--1:9...._.. NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT....13- BUILDING OR WORK
ADDRESS. (<j �- x.^ ... SEPTIC TANK,SEEP,PIT(S)
...a •. _.............
.........:.. -AND/ORD RAINFIELD
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI. CESSPOOL DRYWELL I]
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
T.0 COMPLY WITH ALL.000N.TY ORDINANCES AND STATE LAWS. ALTER:REPAIR.8.EWEROR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSALSYSTEM
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HO USE$EWER.
AND STATE OF CALIFORNIA OR.THAT 1.AM THE LEGAL.OWN-
ER OF THE ABOVE DESCRI ED SIDENTIAL PROPERTY. BACKFILL SEPTICTANKS
* SEEP.PIT.(S) CESSPOOLS'
SI
OF'PERMGNATUREITTEE r,...._..:....:.._.._.. .._......_.. �._.
46A642D 663 1/55 's
• �r
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 S�PERMIDEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS S01
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
EGA SE ER SEPTIC: SEWER BUILDING ADDRESS:
TR: 14341 LT: 2 EXIST OCC GRP: R3 10209 OLIVE ST
BLDGS. NOW ON LOT: TEMP CA 917803347
ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: BALDWIN
8586-026-002 ORIGINATION: THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
TENANT:- MANHOLE REFERENCE: UPPER/LOWER; ISSUED ON: PROCESSED BY: -EXPIRES ON:
COUNTY IMPROVEMENT NUMBER: 06/23/99 LC 70/99
OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINAL B CODE:
BAINS GAGAN PRIT SINGH;BALAGGAN BHU - JOB NUMBER:
10209 OLIVE ST TRUNK PERMIT NUMBER:
TEMP 917803347 ROAD PERMIT NUMBER: DESURLPILON OF WORK
AFFADAVIT: NO MASTER BATHROOM AND LAUNDRY SEWER NECTION TO EXISTING
WAIVER: NO SYSTEM
APPLICANT: TEL. 0: EASEMENT: NO
SAME AS OWNER -
RECORD INSTRUMENT N R- RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREETsWtDEN-iN
STATE ENCRO'CH EN- ERMIL.1 B;ER:
SAMEASTOWNER TEL. N0: - //� PEE�Q/�RPP OVALS DATE INSPECTOR SIGNATURE
LIC. NO FEE DESC P'�-I:ON: QUANTITY: 110M: AMOUNT: HOUSE SEWER
;0,7/PERM'I ISS�NC FEE 27.75 CONNECT ADDITIONA
�,,.9 CdNN jl' -fla�LDS
%00 EAC 30.45 BUILDING OR WORK
RC C OR. ENGINEER: L. 0: T L FEES, 58.20
1
SEPTIC TANK, SEEPAGE
+ LIC. N0: X1111111 1 AND/OR DRAIN FIELD
DRYWELL —
SEWER MAP BOOK: PAGE: -T[� Q ��l /]�n(�\ A TER, REPAIR, SEWER OR
Lyr I F- u� SEWAGE DISPOSAL SYSTEM
DISCONNECT PLUG AND
ABANDON HOUSE SEWER —
o
! Sa14�6
BACKFILL SEPTIC S
SEEP. PIT _ CESSPOOL _
GRAYWATER SYSTEM
Service Tha��ct
REPORT ID: DPR266 ROUTE TO BS0508