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Home My Public Portal About6143 ROSEMEAD BLVD_Sewer__ DEP'Alt'MENT OF COUNTY ENGINEERi/Ett-SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY. PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING ADDRESS FOR APPLICANT TO FILL IN LOCALITY BUILDING NEAREST ADDRESS CROSSST. LOCALITY DISTRICT NO. SERIAL NO., PERMIT NO. NEAREST A S CROSS ST. ---- `RECEIVED BY Ready for Inspection DATE ISSUED OWNER MAIL ADDRESS USE ZONE OCCUPANCY MAP BX PG CITY TEL.NO. CONTRACTOR - CO.IMP.NO. ADDRESS ------ JOB NO. CITY TEL.NO. -- — TRUNK PERMIT NO. [� STATE REGISTRATION NO. ❑ COUNTY ROAD PERMIT NO. LEGAL DESCRIPTION LOT NO. STATE ENCROACHMENT . PERMIT NO. BLOCK TRACT INDUSTRIAL SIZE Of LOT N0.8F BLDGS. WASTE APPROVAL NOW ON LOT CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE PUBLICSEWER @ S 3.50 RECEIPT N0. DATE BY HCIJSE SEWER-GONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO- i DATE (BY 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 STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER, LOWER TYPE OF CONNECTION LENGTH FROM Y. CURB : M.L.TO P.L. OWNERS PERMIT ¢ I 00 AUTHORIZATION TOTAL FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE SIGNED THIS...... DAY OF-. r-..:. ............. 19...... NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT.--.'-- ----•--....:..-.., -- BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) ADDRESS - - - AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL 0 DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE I TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS, SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS(� SIGNATURE SEEP.PIT(S)ED CESSPOOLS OF PERMITTEE---. • - -...- --------------------------------- 46A642D 663 1/53 DEPAWrMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER LD NG7> I ADDRESS r� FOR APPLICANT TO FILL IN LOCALITY , NEAREST aooRl=ss 6 e° +' ' rt3'-i -a�,c_e CROSS ST. LOCALITY 7— DISTRICT N • SERIAL NO. PERMIT NO. �� Z,r 72 NEAREST f`_ S CROSS ST. RECEIVEDP> Ready for Inspection DATE ISSUED OWNER MAIL jam'' ADDRESS ii ( «,.,eCKr�..�.L U EZONE- OCCUPANCY MAP - �— BK PG CITY TEL.NO. ,f CONTRACTOR x CO!O.IMP.,NO. 7,3 3,7/�L ADDRESS S JOB N0. CITY ' 4Y. TEL.NC J TRUNK PERMIT N0. STATE - REGISTRATION NO. ' COUNTY ROAD PERMIT N0. LEGAL DESCRIPTION LOT NO. 7— STATE ENCROACHMENT --.----_. PERMIT NO. BLOCK TRACT S INDUSTRIAL WASTE APPROVAL SIZE OF LOT � NO.OF BLDGS. NOW ON LOT 1. CHARGES USE OF BUILDINGS S { /C'7 CONNECTION CHARGE FEi NO. DESCRIPTION OF WORK FEE -- HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE PUBLICSEWER $ 3.50__ RECEIPT NO. I DATE BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR 7 EXC PTION`�ECORDED WORK TO HOUSE SEWER__ 1.00 SEWER OR DISPOSAL SYSTEM 1.00 NO. DA�E BY ALTER OR REPAIR EXISTING DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR / / — PITS AND/OR DRAINFIELD 2.00 STATION / G '�� DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE... UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ 1 00 Y. CURB P.L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE - I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE SIGNED THIS-------------- ----DAY OF................ .._ _._.19..._... NEW HOUSE SEWER � OWNER OR CONNECT ADDITIONAL OWNERS AGENT.............. BUILDING OR WORK ...... SEPTIC TANK,SEEP.PIT($) ADDRESS....................................... --------------------•-------------- - AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL E] DRYWELL 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 SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND DISCONNECT PLUG AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUGAND AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILLSEPTIC TANKS � SIGNATURE SEEP.PIT(S)o CESSPOOLS -6:. // OF PERMITTEE —.... -.. _.i r._ .'.�_�.C�........................ 76A642D 663 1/53 .. .a K COUNTY OF LOS ANGELES t TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS BE 0508 0108310003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE a PHONE: (626) 285-0488 EXT: LEGAL ID: SEWER / S C: SS: TR: 5904 LT: 78 EXIST OCC GRP: 6143 ROSEMEAD BL BLDGS. NOW ON LOT: TEMP CA 917801541 ASSESSOR INFORMATIONE CONNECTION TYPE: NEAREST CROSS STREET: LONGDEN 5384-004-023 ORIGINATION: THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY LENGTH ML TO PL: STATION: DEPTH: MANHOLE REFERENCE: UPPER/LONER: ISSUED 0 ROC : EXPIRES ON: 08/31/01 JK 02/27/02 COUNTY IMPROVEMENT NUMBER: OWNER: T L. O: PLAN CHECK NUMBER: FIA DA E FINAL BY: CODE: GOOLSBY CHARLES T;CRAIG T - JOB NUMBER: q 6143 ROSEMEAD BL TRUNK PERMIT NUMBER: W dn TEMP 917801541 ROAD PERMIT NUMBER: S P O 0 AFFADAVIT: NO SEWER LINE REPLACEMENT 0 E ONLY WAIVER: NO APPLICANT: TEL. NO: EASEMENT: NO MIKE BURNES (626) 305-0560- 800 GRAND RECORD INSTRUMENT NBR.: RECORD DATE: SPECIAL CONDITIONS: COVINA 91724 HIGHWAY/STREET-W.ID'EN3N6:_� STATE ENCROKCHMENT�PERMIT�-NUMBS' CONTRACTOR: TEL. N0: !�!/�t� �F,EES3 PAID,t APPROVALS DATE INSPECTOR SIGNATURE MR ROOTER (626) 705-3419- �•,/ \ ; E 800 N. GRAND AVE. LIC. NO F,EE•DESCR•IPjION:r/'s QUANTITY: UOMe.. AMOUNT: NEW HOUSE SEWER COVINA, CA 91724 767047-C42 * 21 01 PERMIT ISSUANCE FEE,--- �� ' 27.75 CONNECT ADDITIONAL 15 ALT%REPVHOUSE.,9EWl:R1 r" 1.00 EA� ', 30.45 BUILDING OR WORK ARCHITECT 0 E G EL. N0: II �_ I''I;` II'-TOTAL FEES y,',�+ 58.20 SEP CS P G LIC. N�O': / -----_- - --. I - y �, AND/OR DRAIN FIELD DPYWELL _ SEWER MAP BOOK: PAGE: ;;- 1 ' i'.' ;'; ALTER SEWER OR SEtdAG SPOSAL SYSTEM i DISCONNECT PUG AND ti! y ---- -- r i - I`� ' r,:' BAC S P C ABANDON HOUSE SEWER �'l ^- t .'s, SEEP. PIT _ CESSPOOL _ ,�n`��j�i /� ` :F' 's• GRAYWATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID: DPR266 ROUTE TO BS0508