HomeMy Public PortalAbout10647 OLIVE ST_Relocation__ COUNTY OF'LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
SE 0508 0806300003
DEPARTMENT OF PUBLIC WORKS
9701 LAS TUNAS
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ISEWER / SEPTIC: SEWER I BUILDING ADDRESS:
ILEGAL ID: I 10647 OLIVE ST
ITR: 7690 IT: 1 BL: .001 (EXIST OCC GRP: TEMP CA 917802843 1
IBLDGS. NOW ON LOT: I NEAREST CROSS STREET: EL MONTE I
(ASSESSOR INFORMATION NUMBER: (CONNECTION TYPE: i THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl
DEPTH:
18586-030-002 (ORIGINATION: I
1 [LENGTH ML TO PL: STATION: I
11OCESSED BY:
(TENANT: IMANHOLE REFERENCE: UPPER/LOWER: 1066/30//30/ ON: PR08 SR 12/27/08 N. I
1
1 ICOUNTY IMPROVEMENT NUMBER: IFZNAL DATE FINAL BY. CODE: I
IOWNER: TEL. N0: [PLAN CHECK NUMBER:
ILUONG, TONY T (323) 864-3868- 1JOB NUMBER.
110647 OLIVE ST ITRUNK PERMIT NUMBER: IDESCRIPTION OF WORK
ITEMP 917802843 IROAD PERMIT NUMBER: ICONNECT 2ND UNIT TO PUBLIC SEWER
[ 1AFFADAVIT: NO 1
WAIVER: NO 1 I
IAPPLICANT: TEL. NO: EASEMENT: NO I
LUONG (323) 864-3868- I I
110647 OLIVE ST. IRECORD INSTRUMENT NBR: RECORD DATE: 13PECTAT• CONDITIONS:
ITEMPLE CITY CA 91780 (HIGHWAY/STREET WIDENING: I
1 ISTATE ENCROACHMENT PERMIT NUMBER: I
1 TEL. NO: I FEES PAID [APPROVALS DATE INSPECTOR SIGNATORE
1CONTRACTOR: 1
ITONY TRUNG LUONG (626) 448-2488- 1 I
110647 OLIVE STREET LIC. NO IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[NEW HOUSE SEWER
ITEMPLE CITY, CA 91780 685617 * [ 27.75 ICONNECT ADDITIONAL I i I
101 PERMIT ISSUANCE FEE 1
103 CONN TO PUBLIC SEWER 1.00 CON 46.95 IBUILDING OR WORK I 1
TEL. N0:
[ARCHITECT OR ENGINEER: - i TOTAL FEES 74.70 1
1SEPTIC TANK, SEEPAGE PIT1 I
LIC. NO: I JAND/OR DRAIN FIELD
DRYWELL
1 1 IALTER, REPAIR, SEWER OR
SEWER MAP BOOK: PAGE: i [SEWAGE DISPOSAL SYSTEM
I
1 1DISCONNECT PLUG AND I I I
(ABANDON HOUSE SEWER
(BACKFILL SEPTIC TANKS _1 I 1
1 ISEEP. PIT _ CESSPOOL
1GRAYWATER SYSTEM
I �
I
I I I I I
I* ADDITIONAL DATA ON FILE I I I 1
I 1 I I 1 I
o IREPORT ID: DPR266 ROUTE TO BS0508 I I 1 1
I I
nF rARTBIENT OF COST F.TqGLqEER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING: AND SAFETY PERMIT APPLICATION
• COUNW OF W$ ANGE.LZ8
WILLIAM J. FOX, COUNTY ENGINEER ADDBUILDREINSSG t h t
4L•:�. �-� �1 `..1 � e 1:�= --til`F
_ - e
LOCALI
FOR APPLICANT Tp FILL IN ''r�� i-•-- _
ADHSS . � NEAREST
DR � �
CROSS ST. ry `Cci iri
LOCALITY h �.• E DISTRICT NO. SERIAL NO:. PERMIT NO.
NEAREST / i` .1F /�' ! r ' +I`7 A ��(')"1C, _
CROSS ST: ' f/31•L sx�1� , ;R. l �.r " ,:t'.rr,.r@ "t
—� r- RECEIVED BY Ready for lnaDeotion DATEISSUED
OWNER
MAIL r USE Z6NF OCCUPANCY BK MAP PO
ADDRESS /� Q I/ C i`h t�+�f�r{.rt�!�a••- 1
CITYI ' 4 TEL.NOTIY'.
tt+ r
CONTRACTOR �1J '� ^• r ti %,� �.
CO.IMP.N0. r� G-j z-
ADDRESS •�?-F!� �,/{ e!J �� ,e! JOB.NOr-- -
.
CITYTELAO,,'�/`• {/ A '+ �:_
!.s. TRUNK PERMIT NO.
�-
f,► STATE
REGISTRATION NO. ,,✓�'� f - °� "�t�'1 COU-NTY ROAD PERMIT NO.
DESCRIPTION ,LOT RfO. — �� � ' .1, STATE ENCROACHMENT
PERMIT NO.
BLOCK TRACT 74 ri ° INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF BLDG8. � CHARGES
NOW ON LOT
USE DI /` ✓ C _ CONNEC C;�V CHARGE FEE
BUILDINGS �--. �.• ,� •
NO. DESCRIPTION DF WORK FEE "'-
g
j HOUSE SEWER CONNECTING TO REIMBURSEMENT•FFE
_y PUBLIC SEWER @ $ 5.50 RECEIPT NO. DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
} CONNECT ADDITIONAL BLDG.OR . _ .: v,o►�EXCEPTION REGOR
�r WORK TO HOUSE SEWER 1.00 N0. DATE I BY
ALTER OR REPAIR EXISTING
.SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK.SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATIONS DEPTH
CESSP00 L—D RYW E LL
SPECIAL CONDITIONS ONLY 2.001 '/ MANHOLE REFERENCE
`f .±c kN nT U=--- rLLOO�WERR,,
TYPE OF CONNECTION -_ LENGTH FROM
OWNERS PERMIT ; 1 00 .gip
P.L. M.L.To P.L.
AUTHORIZATION TOTAL FEE i
I HAVE THIS DATE CONTRACTED WITH THE HEREIN ,NAMED
HAVE
TO CONNECT THE ABOVE DESCRIBED EXISTING' APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE,PUBLIC SEWED.; :¢
SIGNED THIS.1% ..��QA,'OF .. .y:�'a_ _�._' ,I�_':G: NEW HOUSE SEWER -,5
,� CONNECT ADDITIONAL
OWNER OR al 0.7 �• { .w � BUILDING OR WORK
OWNER$ Y_
i G . SEPTIC TANK.BEEP.PIT(S)
ADDRESS.... i:.;, �.�.. ..�; `:'': ,�.=._._.�. ._:. _�. AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ TAR APPLI- CESSPOOL 13 DRYW.ELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR.SEWER OR
REGULATING PLUMBING AND SEWER& SEWAGE DISPOSAL SYSTEM
I' HE CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND
ANO/OR LICENSED AS REQUIRED. BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
AND 8TATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)E3 CESSPOOLS
r
OF PERMITTEE. '`'�= ........
--�✓... ' t ' --
76A642A 663 7/53 'J .� i rte_ �, 7177