The URL can be used to link to this page

Home My Public Portal About4818 PERSIMMON AVE_Sewer__ TEMPLE CITY :E808 2`70 6.A 6420 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 48!.8 ,,,�Ti. Persimmon Ave. COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY Temple NE OR APPLICANT TO FILL IN wer--Azus-a—PA. (PRINT OR, ONLY) CROSS AREST ST. LEGAL- __pESCR(pTjq�rq LOT NO, OWNER Jim Graham MAIL BLOCK TRACT -V ADDRESS 140, SIZE OF LOT OF0NBLDGS.LOT ri-Monterey Pario-. No -4% -�f NOW USE OF S DISTRICT NO. GROUP CLASS I MAP ESSPf) Bti BUILDING'S -UIL-DING - CONTRACTOR R3quare Deal Sewer Service ADDRESS 29_1_3 Mlle�xsqn Rd. CONNECTION CITY El Monte TEL. NO. . =44'4 20. STATION DEPTH STATE LIC �CEN SiE N., I. CLASS SS C-42 MANHOLE REFERENCE- -, ,-'7,YAl LOWER DESCRIPTION OF WORK FEE -NIECTIO LENGTH FROM. 2to CUR 75 HOUSE SEWER CONNECTING TO Y- IS P L M.L.TO P.L. 1!��IC SEWER @ $5.00 SEPTIC TANK,_ SEEPAGE PIT-ow— P,C,NO, PITS AND/OR DRAINFIELD CO� IMP, NO. JOB NO HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM $3.00 CONN E T_ADDITION.AL-BLDG.OR AFFID-AVIT-i WAWVl* IASi 0 RFC WORK HOUSE SEWER @ $300 0 TO �O IIISTR,NOAT. OVERF EXTN CESSPOOL.DRYWFLL,MAN HOLE 6 $5.00 - HWY. OR ST.WIDENING 0 AL7ER.FFElP-A—lR OR A-BANDON - - 7-fW6'-JS-E----- -- SEWER OR DISPOSAL SYSTEM STATE ENCROACHMENT u PERMIT NO LLJ CL INDUSTRIAL V) WASTE APPROVAL s. __,____I.ARGES 0WNER;;S---j-jWRmjT $ 300 AUTHORIZATION T TOTAL FEE CONNECTION CHARGE FEE HAVE AT THIS DATE A CONTRACT WITH. THE HEREIN NAMED CON- REIMBURSEMENT FEE T RACTORT 0 CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO T I,E PUBLIC SEWER. APPROVALS DATEINSP IFTOR'S SIGNATURE SIGNED THIS—DAY OF----19— OWNER OR NEW HOUSE SEWER OWNERS CONNECT ADDITIONAL BUILDING OR WORK ADDRESS------- SEPTIC TANK,SEEP, PIT S) IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELO A,N o STATE THAT THE E ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUM a ING AND SEWERS, CESSPOOL [I DRYWELL I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND'OR ALTER,REPAIR,SEWER OR I L ICEE NSEDAS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER dF, AND INTEND TO DISCONNECT PLUG AN t, 9ESi E IN THE ABOVE DESCRIBED RESIDENTI IL PROPERTY. ABANDON HOUSE SEWER SIGNATUREOF PEjqmrrTr.E BACKFILL SEPTIC TANKS El SEEP,PlT(S) 5 L 0 CESSPOOL-5 1 VALI ATION JACK R. ALLEN CK. 0 CASH SUPERVISING MECHANICAL ENGINEER A C E808 2 170 76.A.642.L- APPLICATION FOR PERMIT COUNTY OF LOS ANGELES 'SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 4ef)-- COLEMAN W. JENKINS, SUPT. OF BUILDING ADORE LOCALITY z /Z� zL -z- A—T NEAREgf RAPPLICANT TO FILL IN CROSS ST. (PRINT OR TYPE ONLY) LEGAL___._- I�TN DESCRLPTICM L OT NO. OWNER MAIL EI'D Z 3c BLOCK TRA ADDRESS tic? NO. OF BLDGS. N SIZE OF LOT NOW 0 LOT CITY TL USE OF BUILDINGS DISTRICT NO. GROUPCLASSI MAP PS PROCESSED BY SK CONTRACTOR I 4;- I, _7 ADDRESS --CONNECTION CITY STATION DEPTH TEL.- STATe UPPER LIC M.ANHOL �,�:;7"AIENCE _LOWER__OWER_ LICENSE NO: CLASS NO DESCRIPTION OF WORK FEE TYPE OF GONr NrSCTION LENGTH FROM WCURB P.L. M.L.TO P.L._O I.WE CONNECTING TO Y. PUBLIC SEWER P.C.NO, T.P.Tl,,CN.lANl SEEPAGE PIT -11 1..NO. 'IT D, Co.IMP.NO. AiNFIELD $10.00 I Hous-F SEWER CONNECT-IN.G TO PERMIT NO. PRIVATE DISPOSAL SYSTEM 53.00 TRUNK PERMIT NO. AFF16-ivill I WA TR.No. CONNECT ADDITIONAL BLDG.-OR FAsrmfmT RECORD. INS DATE WORK TO HOUSE SEWER @__!3 00 u OVERFLOW SEE PAGE PI77.D - — _ _ - ii- Aft;FIFLE Al. EXTN CF SSPOOL.DRYWELL.MANM OLE $5�00T. HWY.OR ST.WIDENING A L40R _r""A�!�HOUSE SEWER 0- STATE ENCROACHMENT _AZI.00— (j PERMIT NO, INDUSTRIAL Vi WASTE APPROVAL 2: CHARGES OWNER'S PERMIT si 00 N CHARGE FEE AUTHORIZATION TOTAL FEE CONNECTION mr� — I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR T CONNECT THE ABOVE DESCRIBED EXISTING DWELLING DATE PUBLIC Co`4 --I--.SP C-T-R'..I.NATLIR. TO THE L iC SEWER. APPROVkLS SIGNED THIS DAY OF 19 OWNER OR ,- !! rt NEWe HOUSE SEWER OW NERS AGENT 61"izr '4 -, ___ -_ CONNECT ADDITIONAL BUILDING OR WORK SEPTIC TANK.SEEP,PITJS) --- iDHEREBY ACKINIVIWLFOGE-�, THIS APPLICATION AND/OR DRAINFIELO AN STATE. THAT THE ABOVE IS C RRECT AND AGREE TO COMPLY WIT H ALL, COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. IRS. CESSPOOL ❑ ORYWELL IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED 13Y LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA A OR THAT I AM THE ALOWNER OF, AND INTEND TO — ----- - RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. DISCONNECT PLUG AND ABANDON HOUSE SEWER SIGNATURE TANKS A 0 PERMITTEE_____ BACKFILL SEPTIC TLj S 1 ❑ SEEP.PIT I CESSPOOLS VMDATION JACK R. ALLEN CK. W 0. CASH SUPERVISING MECHANICAL ENGINEER ^.UA2nU 63 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DiSPOSAL BUILDING AND SAFETY DIVISION D S TAILR F County Engineer TOWN A. LAMBIE ADDRESS .;/Vol lk� WILLIAM A. JENSEk, Supt of Building LO-:AT-iTy T NEAREST ,SS ST CROSS ST. FOR APPLICANT TO FILL IN DES P,lop" CHLOT NO, 0 WNER a I MAIL BLOCK 7R9C ADDRESS NO OF SLOG S. SIZE OF� LOT NOW ON r LOT --:TI TEL, NO. USE OF BUILDINGS DISTRICT NO. GROUP MAP PRO CESSCI)BY SK PG CONTRACTOR ADDRESS CONNECTION DATA —--------- STATION DEPTH C I T'e EL. NO. ff 5T�AYEMANHOLE REFERENCE Rii-GISTRATION N11. COUNTY C, NO. DESCRIPTION OF WORK FEET'Y FEOF CONNECTION LENGTH FROM -H 0 16 5 E-S-EW E R CONNECTING TO Y. CURB P.L. M.L,TO P.L. PUat.IC,SEWER $5,00 N211. P.C.N.O. CO. [MP.NO. JOB NO. F!TS AND;OR DRAINFIELD HOUSE SEWER COP NF TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSIM @ $3,00 --AFIHD]A—v EASEMT RECORD. INSTR. NO. DATE WORKTO HOUSE SEWER 00— A—- SEEPAGE PIT DRAINF!ELD EXTN,.CESSPOOLz: .L'RYWEI-�-.-M.A.NHI)[.E @ 35 00 HW Y.OR ST.WIDENING' �BANDON HOSE N EE E W E R O -1`--7.L S Y S T E M @ S ----- -— :00 STATE ENCROACHMENT F1:1,1,:T NO, INDUSTRIAL _WASTE APPROVAL. CHARGES OWNER7s--7-PERMIT 2, 00 CIINEITIIN CHARGE FEE AUTHORIZATION I �6�TAL--F—E-E— 7:- I HAVE AT THIS DATE A C014TRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE TRACTOR I DWELLINGCONNECT THE ABOVE DESCRIBED EXISTINGDWELLINGTH E p ibl-ic srWER, APPROVALS DATE. INSPECTOR'S SIGNATURF SIGNED THtS--DAY ------—) OW14ER OR NEW HOUSE SEWER OWNERS AGENT— -—----- —-- CONNECT ADDITIONAL BUILDING OR WORK ADORIESS_ SEF-Tt rTANK,SIErP.PiT(5) I PERIEBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIE:'D AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTYORDINANCES AND STATE; LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL HEREBY CEP-,!FY THAT I AM PROPERLY REGISTERED AND OR ALTER, REPAIR,SEWER OR LV ENSED AS REQUIRED BY :_OS ANGLES COUNTY AND STATE -OF SEWAGE DISPOSAL SYSTEM C AL;FORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RES:1DF IN., THE ABOV4�/DESCR;,BED RESIDENTIAL PROPERTY, I N CT PLUG UIG AND ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS L-1 OF PERMITrEE-,,1/ SEEP,Pir(s) Ej cLssrooLs VALIDATION— —`, ROBERT A. WOOD SUPERVISING NIECHANiCAL ENGINEER CK. M.O. CASH y D �ESOS10-f3 6A642 1) APPLIC�ATION FOR PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADURES WILLIAM A. JENSEN, Supt of Building LOCA, N NEA. _ c!Ty CROSS FOR APPLICANT TO FILL IN L ow NE R 71 _z MAIL A'I' BLOCK A 0 D PEE.S S NO. Or SLOGS. SIZE OF LOT NOW 0 I'l LO-1 TEL., NO. USE OF Y BUILDINGS D STRICT NO,..GROUFI MAP P q RocrssF-D]/ 4'.�01_ ?K "I �`__ 11 11 _ c_ -TRACTOR CON CONNECTI ON DATA ADD FS'a —---------- ,�e STATION DEPTH '0t&T F L. z� MANHOLE REFERENCE _O, Ty CESCRIPTfION OF WORK 'i LE HOUSE 5 TTYPE OF CONNrCTION E7 I a, , Y, CURB P,L, M L.,TO P.L. EWIFIR 5NNCETIWG 0 nc OAR PUBLIC SEWER @ $s.00 C TANK SEEPAGE PIT OR P.C.NO. i SEPTCO. IMP.NO. JOB NO. SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. ert PPI_v ATE!DSP AL SYSTEM @ $3.00 C,CNNE6T'� .6�NONAU SLD-OR j( WORK-0 HOi AFFIDAVIT WM CORD, !NSTR,NO DATE ISE SEWER j rOd_RPrLOW SEEPAGE PYT,DRA!NFIELD 55.00 HWY. OR ST.WIDENING J7� ALTER,RC�AIR OR-,8ANrON HOLs5. IDSAL SYSTEM S3.00 STATE:ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES ___ PERMIT 00 OWNE.R'S 4_____ CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE e'' . ____ - I HAVE AT TH'S DATE A CONTRACT WITH THE HER.E'N NAMED CONREIMBURSEMENT� TRACT R TOE�. ABOVE DESCRIBED EXISTING r,WF!L.:NG APPROVAL.? COCO`4Nr(T 7 TO THE �UOIL'c SEwc.R� ALS i DATETNSPEC1'OR'S SIGNATURE SIGNED THJ s DAY OINNFR r.IR NEW HOUSE SEWER OW NERS AGENT—__ CONNECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TAN'K,_&EE.P.-T(S) —1 HPr,E9Y A-KNOWLEDGE THAT I HAVE: READ THIS APPLICATION A,ND/.OR DRAINFIELD AND STA-E THAT ,..._,VE il, CORRECT AND AGREE TO COMPLY V,r,.r 4 L. Q.�UNY ORDINANCES AND STATE LAWS REGULATING IMeL7 ;NG AND SCwER$. CESSPOOL CRYwELL I HERESY IERTIF? THAT � AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR E -35 ANGLES ES -E C D AS PrQUIRED BY L ANj_ C,1UN7Y AND STATE OF SEWAGE D15POSAL SYSTF.M. j DISCO hiNECTvP6.0 G AND C CR NiA OR '�-'-HAT I AM THE LEGAL OWNER OF, AND !NTENO To FES'L PROPER ABANDON HOUSE SEWER N, THE ABOVE DESCRIBED RrSIOENTtAt� 01' PERM 7EACKFiLl SEPTIC TANKS CESSPOOLS SEEP,PIT IS., _j VALIDATION-— ROBERT A. WOOD SUPE, "RVISNG MECHANICAL ENGINEER CK. M.O. CASH 7 a r-663 f2.5.9 APPLICATION 6& APPLICATION OR PERMIT 1 6 E DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE D I S P'O SA L Deportment of County Engineer County of Los Aageles BUILDING WM.J. PDX. COUNTY ENGINEERADDRESS CASSATT D.GRIFF"Ir^I,SUPT OF BUILDING +LOCALITY J J _ �r� �� ate' -F R. ANT TO FILL INA �I:I'CNEAREST CROSS ST. ✓"..a.y' ,.ti.r;:-�,,,•`>+>' e .r•� LEGAL _ .. DESCRIPTION LOT N0. " OWNER BLOCK Ara TRACT" ' ' �4DDRESS .1ts�J �"-✓ : NO.OF BLDGS. �' ,,,. SIZE OF LOT --3 y a X "ci X11 NOW ON LOT -�i.. tTYe a % ;- ._ �'7EL.NO. USE OF3 BUILD NGS :All'-141, 1, yc:r..l_l;,r. DISTRICT NO. GROUP MAP y,y,�� ,y' I BK PG CONTRACTOR LST - +�4. .'dy.. ,..e%%�' �. ,. _ �,d_., 4� ADDRESS ,P re 's CONNECTION DATA °' shy. STATION DEPTH C1TY��. �,r .... TEL. NO �'.�v� � �e.t a:g. - � _ .,� -� STATE IdANHOLE REFERENCE REGISTRATION NO. „�r � �' If� OVE^,A- TYPE OF CONNEC7'10}�,--v LENGTH FROM NO. { DESCRIPTION OF WORK FEE _- CURB rO N.L.To.P.L. r ! 140USE SEWER CONNECTING TO PUBLIC SEWER_ _ _ (.�$__3.50 _ HOUSE SEWER CONkEC71Y3G 70 PRIVATE DiSPOS4_L_SYSTENY - �i CONNECT ADDITIONAL BLDG. OR Co. IMP.NO. JOB, NO. WORK TO HOUSE SEWER__ 1,00 . .—.-- ---- ~i ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM _ 1.00 i I TRUNK PERMIT IT N0,! ROAD PERMIT NO.�,u__ i DISCONNECT AND ABANDON SEWER � TATE ENCROACHMENT AND/OR_ DISPOSAL SYSTEM ,Y 00 1 PERMIT NO. SEPTIC TANK, SEEPAGE PIT OR - •-- ._.. —.-_._ PITS AND/OR DRAINFIELD 2.00 INDUSTRIAL WASTE APPROVAL -SPECIAL DRYWELL i ti SPECIAL CONDITIONS ONLY -2.00_I h_ CHARGES CONNECTION CHARGE FEE Oi8V FTPERMITPERMITs -- --------- 's t f 00 —--—. ---- —---------- AUTI'IORMATION TOTAL FEE ,1:. L',” REIMBURSEMENT FEE 1 HAVE THIS DATECONTRACTED WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEW<R -' --"'- ---- - -- ----- ----- Y '. NEW HOUSE SEWER SIGNED THIS DP,OWNER CONNECT ADDITIONAL OWNERS AGENT-! - """ v;','.✓a' tU[LDiNG OR WORft �__ .�..—._. _...._.�. SEPTIC TANK SEEEP, PIT(S) ADOR£5S,t=_�' k" x*� ! �t"�-' - 3�` is _ AND/OR OR INFIELD 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THiS APPLICATION CESSPOOL LE. DRYWELL❑. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH AUL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER, REPAIR,SEWER OR PLUMBING AND SEWERS, SEWAGE DISPOSAL SYSTEM _ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR D[SCONNECT PLUG AND _ LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _ EISCO ON CTPLU SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE .._..NDO __�.. DESCRIBED RESIDENTIAL PROPERTY. - _ EACKFILL SEPTIC TANKS 0 SEE?,PIT(S) 0 CESSPOOLS 0 SIGNATURE OF PERMITTEE WILLIAM J. PDX,COUNTY ENGINEER VALIDATION BY BY .w .. DEPUTY -- y DEPUTY BY BY ¢� DLPUTY >�-�"'. �� -� DEPUTY