HomeMy Public PortalAbout5936 RENO AVE_Sewer__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS SE 0508 9702040017
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT: _
LEGAL ID: SEWER / SEPTIC: S DING ADDRESS:
TR: 5904 LT: 147 UN: .002 EXIST OCC GRP: 5936 RENO AV
BLDGS. NOW ON LOT: TEMP CA 917801528
ASSESSOR 0 0 CONNECTION TYPE: NEAREST CROSS STREET:
5384-017-013 ORIGINATION: THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
EN MANHOLE REFERENCE: UPPER/LOWER: ISS 0 PROCESSED Y: EXPIRES ON:
02/04/97 TC 02/04/98
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINAL BY: CODE:
RODENBUCHER ROBERT R;CAROLE A (818) 285-2030- JOB NUMBER:
5936 RENO AV TRUNK PERMIT NUMBER:
TEMP 917801528 ROAD PERMIT NUMBER: D SCR TION 0
AFFADAVIT: NO REPAIR SEWER LINE IN PARKWAY
WAIVER: NO
APPLICANT: T L. N0: EASEMENT: NO
RESCUE ROOTER (800) 869-6942-
RECORD INSTRUMENT�NBR" REC R A•r. SPECIAL CONDITIONS:
s/ _
HIGHWAY/STREET W}tiDENZNG•-�- �--•�` ®®®
STATE ENCROACHMENT PER IT,NUMBER:
CONTRACTOR: TEL. N0: z` f = `" 'fEES PAID ��" APPROVALS DATE INSPECTOR SIGNATURE
RESCUE ROOTER - COVINA (800) 869-6942- J ;� '� �� �� ;�
681 SAN BERNARDINO LIC. *0 FEE DESCRIFT�ION��� _ - �WUANTITY�: UOM�: AMOUR, R
COVINA, CA 91724 C42 B
01 PERMIT ISSUANCE,FEE ,r - _ ----27:75li CONNECT ADDITIONAL
15 ALT/REP HOUSE--SEWERS-- �, j ;j'f�?OOyEA,O' I' ' 30.30 - BUILDING OR WORK
ARCHITECT 0 ENGINEER: L. 0: - j �' �.�'L' T07AL�FEESk=� u:r:�II 58.,
II_ : _ - _ SEPTIC TANK, SEEPAGE-
LIC. NO: I'. F 1', � `_—:-11 AND/OR DRAIN FIELD
DRYWELL
SEWER MAP BOOK: PAGE: ALGE TER, REPAIR, SEWER OR CN
��SEWADISPOSAL SYSTEM
DISCONNECTP G AND
ABANDON HOUSE SEWER
13ACKFILL SEPTIC TANKS
SEEP. PIT _ CESSPOOL _
GRAY T R S STE
I
I
* ADDITIONAL DATA ON FILE
- I
REPORT ID: DPR266 ROUTE TO SS0508
✓s°` �
`BDt 3 6.
SA6420 APPLICATION FOR PERMIT
.OUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING p T
LOCALITY
NEAREST 4' , ,G'`
FOR APPLICANT TO FILL IN CROSS ST. J
DESCRIPTION LOT NO. ,( i OWNER
-- _--- MAI
BLOCK —___---TRACT ADD.E
�E NO. OF SLDGS,
SIZE OF_LOT,5 NOW ON LOT _ CITY L. NO.
USE OF �t; _ — DISTRICT NO. GRO�i�P MAP PROCESSED BY
BUILDINGS !
BK PG
CONTRACTORADDRES
CONNECTION DATA
o.�
CITY � ��OSTATION- DEPTH
>'. yy�{�N .. -7 -_
UPPE
STATE f-- CRSS MA N H&LE REFERENCE LOW R
LICENSE NO, _
NO. DESCRIPTION OF WORK _FEE TYPE OF'CsONNECTION LENGTH FROM
HOUSE SEWER CONNECTING TO �— Y. 0 RB P.L. M.L.70 P.L.
PUBLIC SEWER @ 35 OO I P.C.NO0
SEPTI TANK.SEEPAGE PIT OR . fl
_—
PITS AND/AOR DRAINFIELD 310.00 CO_IMP.NO. __ .10BN0'/" u
!HOUSE SEw EP.CONNECTING TO TRUNK PERMIT NO. ROAD RMIT NO. �
, PRIVATE DISPOSAL SYSTEM $3.00I_ _. – fi
CONNECT ADDITFONAL BLDG FIDOR �, AFFIDAVIT 1I WAIVER EASEMENT ". EC D.INSTR.NO.DATE !fid
I WORK TO HOUSE SEWER @ $3.00 y--- u
r-- –4 OVERFLOW SEEPAGE PIT.DRAINFIELD 1 I __
_ EXT—.1 ESS POOL.DR WELL.MANHOLE @ $5.00_ I —_ —� Q.
HWY.OR ST.WIDENING '^
ABANDON HOUSE - f
POSAL SYSTEM _ � 53.00_ -_�_._!g STATE ENCROACMM —_—-
-_- PERMIT NO.
INDUSTRIAL f`
—+ f WASTE AP�OVAL
-I�—`-- _ CHARGES
OWNER PERMIT Zoa ------ ------ —
� CONNECTION CHARGE FEE
AUTHORIZATION TOTAL. FEE - ---I tir r ti' --- — ----- - -
1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE
TRACTOR TO CON NE T THE ABOVE.DESCRIBED EXISTING DWELLING APPROVALS
TO TH.E PU ElL C. SE R. DATE INSPEO70 R'S SIGNATURE
SIGNED THI _ DAY OF
OWNER OR NEW HOUSE SEWER
OWNERS A —
CONNECT ADDITIONAL r
UILDINGORWORK
ADDRESS _ _ __ _-
I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICA ION AND/O ND TANK.SEEP,PIT(S) y y f k
OR DRAINFIELD i€ 8
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ------------- ,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CESSPOOL El DRYW ELL ❑
PLUMBING AND SEWERS. _ __ _ _
1 HEREBY CERTIFY THAT ! AM PROPERLY REGISTERED AND/OR ALTER.REPAIR.5EW ER OR
LICEN SEDAS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM
CALIF'0RN IA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND ---I���----���
RESIDE IN. THE AABCOE,SC EORESIDENTIAL PROPERTY. ABANDON HOUSE SEWERSINATURE -- --- --- BACKFILL SEPTIC TANKS ❑
4F PER - - SEEP.PIT(S) ❑ CESS.POOLS ❑
,s 'VALIDATION JACK R. ALLEN
{' K.J M.O. CASH SUPERVISING MECHANICAL ENGINEER
- /C
5.0 11��
E808 3-62 - -
6A642D APPLI TION FOR PERMIT
COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
0.
JOHN A. LAMBIE, COUNTY ENGINEER ADDREss �__ ���e C - ?
COLEMAN W. JENKINS, SUPT. OF BUILDING
LOCALITY
NEAREST ---f-
FOR APPLICANT TO FILL IN CROSS ST.
LEGAL
DESCRIPTION LOT NO. OWNER
MAIL �!
BLOCK TRACT ADD ' c! ,a-4.,
NO. OFBLD
SIZE. OF LOT NOW ON LOT CITY --� } • TEL, NO.
USE OF
BUILDI DISTRICT NO. GROUP MAP PROCESSED BY
HK PG
CONTRACTOR
CONNE_C_TION DATA
STATION 'ti_a DEPTH
I TEL. Ngiy- ,P .l
STATE
LICENSE NO: CLASLIG.
. S MANHOLE REFERENCE -� —
i I' !^• /' � ..-t=� LOWER
N DESCRIPTION OF WORK FEE _ TYPE OF LENGTH FROM
Co .,�
L � �I.L>iFCTI ON
HOUSE SEWN
ER CONNECTING TO --rT�" Y. g`GU RBT P.L. M.L.TO P.L. _..�
PUBLIC SEWER _ @_ $5 A0 fes_ P.C.NO. 0
SEPTIC TANK SEEPAGE PIT OR I CO. NO. `_ __ JOB NO.
PITS AND/OR DRAINFIELD @ $10.00
HOUSE.SEWER CONNECTING TO -f TRUNK PERMIT NO ROAD PERMIT NO.Z3e7:I�(
PRIVATE DISPOSAL SYSTEM _ @ $3.00
C. 4 T yq
j CONNECT ADDITIONAL BLDG OR gFFIDAYIT WAIVER rEASEREMT RECORD. 0
D.INSTR.NO. DATE
WORK TO HOUSE SEWER @ $3.00 1 I I 1
OVERFLOW SEEPAGE PIT.DRA!NFIELD I I _ _ _ Lu
EXTN_CE55POOL.DRYWELL.MANHOLE @ $5.00 _
-- d----- - - - - - - --------- --+-- HWY.OR ST.WIDENING �
ALTER,REPAIR OR ABANDON HOUSE i _
SEWER OR DISPOSAL SYSTEM @_$3.00 __ STATE ENCROACHMENT �— z
PERMIT NO.
_.____.-__-_
--- —�-�------ IN PUSTRIAL -
WASTE APPROVAL.
� CHARGES
OWNER"S PERMIT_ — 2. oo -- - --"— —
'� CONNECTION CHARGE FEE
AUTHORIZATION TOTAL FEE --- --------- -
IHAVE AT THIS DATE ACONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE
TRACTORTO CONNECT THE ABOVE.DESCRIBED EXISTING DWELLING ---- - -- ------
TO THE PUBLIC SEWER. APPROVALS DATE INV GTOR S?SIGNATURE
SIGNED THIS DAY OF
OWNER OR NEW HOUSE SEWER F `'
OWNERS AGENT CONNECT ADD,ITI.ONAL
BUILDING OR WORK
ADDRESS________—
SEPTIC TANK,SEEP,PIT(S)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS .APPLICATION AND/OR DRAINFIELD
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY --�-- --_--- --
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑
I HEREBY CERTIFYTHAT I AM PROPERLY REGISTERED AND/OR ALTER.REPAIR.SEWER OR
LICENSED AS REQUIRED BY LOG.LES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM
CALIFORNIA OR THAT 1 AM THE LE AL OWNER OF, AN INTEND TO DISCONNECT PLUG AND
RESIDE I Te ABOVE R1 RESIDENTIAL � ABANDON HOUSE SEWER
SIGN FILL SEPTIC TANKS ❑ I —
-------- —_ "-- -"-- - SEEP.PIT(5) ❑. CESSPOOLS ❑ I
VALIDATION--— JACK R. ALLEN
CK. M.O. CASH
SUPERVISING MECHANICAL ENGINEER
(,�
l