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Home My Public Portal About5813 ROWLAND AVE_Sewer__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0612120001 -BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 93.780 PHONE: (626) 285-0488 ERT: LEGAL ID: SEWER / SEPTIC: SEWER BUILDING ADDRESS: TR: 6561 LT: 408 EXIST OCC GRP: 5813 ROWLAND AV SLOGS. NOW ON LOT: TEMP CA 917802239 ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: 8587-030-026 ORIGINATION: THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C LENGTH ML TO PL: STATION: DEPTH: TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: PROCESSED BY: EXPIRES ON: 12/12/06 JK 06/10/07 COUNTY IMPROVEMENT NUMBER. OWNER: TEL. NO: PLAN CHECK NUMBER: F D FI CODE: NGO, ROGER (213) 910-0442- JOB NUMBER: 5813 ROWLAND AV TRUNK PERMIT NUMBER: TEMP 917802239 ROAD PERMIT NUMBER: DESCRIPTION OF WORK AFFADAVIT: NO CONNECT GUEST HOUSE TO PlWiTr SEWER WAIVER: NO APPLICANT: TEL. NO: EASEMENT: NO SHEENA (213) 910-0442- 5813 ROWLAND AVE RECORD INSTRUMENT NER: RECORD DATE: SPECIAL CONDITIONS: TEMPLE CITY CA 91780 HIGHWAY/STREET WIDENING: STATE ENCROACHMENT PERMIT NUMBER: CONTRACTOR: TEL. NO: FEES PAID APPROVALS DATE INSPECTOR SIGNATURE NGO, ROGER (213) 910-0443- 5813 ROWLAND AVENUE LIC. NO FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: NEW HOUSE SEWER TEMPLE CITY, CA 91780 NONE 01 PERMIT ISSUANCE FEE 27.75 CONNECT ADDITIONAL 03 CONN TO PUBLIC SEWER 1.00 CON 46.95 BUILDING OR WORK ARCHITECT OR ENGINEER: TEL. NO: TOTAL FEES 74.70 SEPTIC TANK, SEEPAGE PIT LIC. NO: AND/OR DRAIN FIELD DRYWELL _ SEWER MAP BOOK: PAGE: ALTAR, REPAIR, SEWER OR SEWAGE DISPOSAL SYSTEM DISCONNECT PLUG AND ABAMON HOUSE SEWER BACKFILL SEPTIC TANKS _ SEEP. PIT CESSPOOL GRAYWATER'SYSTEM REPORT ID: DPR266 ROUTE TO : BS0508 eA ,2-88 eA'0azo APPLICATION- FOR PER � 19T r COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUP T. OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS LEGAL. DESCRIPTION LOT NO. ;I'.''n OWNER M.AIL BLOCK TRACT - ADDRESS b NO, OF BLDGS. SIZE OF LO? _ ,X _ ( NOW ON LOT ,�4,; i rMA TEL. NO, USE OF BUILDINGS f"'y + :; *�,.� CT NO. GROUP MAPPROCESSEb Y BKCONTRACTO ��.dAooREss J000 CONNECTION DATA CITY - 0 LNO ¢ N ' - DEPTHSTATE - C � � }' IUPPER 3 - °• LE REFERENCE / ..•� LICENSE NO. CLASS '- -� S NO. DES R ION WORK .FEE___ TYPE OF CON TION LENGTH Fl HOUSE.SEWER CONNECTING 70 Y__ URB P.L. M.L.TO P.4 PUBLIC SEWER 55.00 {OZf P.C.NO. SEFTIC TANK SEEPAGE PIT CIR 510:00 Co.IMP.NO. �; JOB NO. PITS ANOf OR URAINFIFLD � HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. >- PRIVATE DI POSAL SYSTEM _—@ 53.00 1.� ' CD CONNECT ADD TIONAL BLDG OR - i AFFIDAVIT WANE fA5EwENi RECORD.INSTR.NO. DATE WORK TO HOUSE SEWER $3.00 i ,.� --- ---"` OVERFLOW SEEPAGE PIT URAINFIELD _—` __-_-_ �- �- -__`-- ccl EXTN.CESSPOOL.ORYWELL,MANHOLE @ 55.00 � --- ----- HWY.OR ST:.WIDENING _. __ _ ' ALTER.REPAIR OR ABANDON HOUSE j SEWER OR D SgOSAL SYSTEM _ ' — ------- ------ - ----- ------- Lj U _ _ _ $3.00 5 ATE ENCROACHMENT -� PERMIT NO !� WASTE APPROVAL -_ _.__- WNER"ra PERMIT— ----- 1 21 Op` --------------- -�- CONNECTION CHARGE FEE AUTHORIZATION F TOTAL FEE G�' -_---_--------_ -- _---- _ 1HAVE .AT THIS BATE A CONTRACT W17H THE: HEREIN NAMED CON- REIMBURSEMENT'FEE TRACTOR TO.,CONNECT THE ABOVE DESCRIBED EXISTING_ DWELLING - - TO THE PUBLIC SEWER. APPROVALS DATE 1 S ECTOR'S SIGNATURE SIGNED THISY OF O'NNER OR A NEW HOUSE SEWER OWNERS AGE NY ---- CONNEC,T ADDITIONAL / BUILDING OR WORK to ADDRESS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THS CArN SEPTIC TANK,SEEP.PIT(S) - AND{OR ORAINFIELD AND STATE THAT THE ABOVE 15 CORRECT' AND .AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ❑ PLUMBING AND HEWERS. CESSPOOL ❑ DRYWELL I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR ALTER.REPAIR,SEWER OR ^ LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM I CALk FORMA OR THAT I AM THE LEGAL OWNER OF. AND INTEND TO —DISCONNECT PLUG AND RESIDE IN, THE ABOVE DESCRIBED R- IOEN TIAL PROPE ABANDON HOUSE SEWER 1 SIGNATURE BACKFILL SEPTIC TANKS OF PERMTT7EE ❑ -- SEEP,PIT(S) ❑ CESSPOOLS- , �/llwll .,/�a .>i,;ryy„ VALIDATION --->, JACK R. ALLEN .✓" 'y CK. M.O. SUPERVISING MECHANICAL ENGINEER CASH 2 1 .fit. 8`D OCT J •1- � td J. L.}.V 0 J r j 76A642D CEB°a4w.°">?' Js APPLICATION FOR PERMIT SEWER - SEWAGE DISPOSAL COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN DISTRICT NO. GROUP MAP ROCESSED BY ING "� // BK - PG ,y ADDRESS r /,.� '�!ir✓'`L N' ,+t rr-J-x l CONNECTION DATA LOCALITY NEAREST STATION DEPTH CROSS ST. I' ✓`"!' .JI.f✓' UPPER MANHOLE REFERENCE LOWER OWNER TYPE OF CONNECTION LENGTH FROM MAIL Y. CURB P.L. M.L.TO P.L. ADDRESS 'ryzi — P.C.NO. CO.IMP,NO. JOB NO. CITY ( .T -TEL.NO. �� LEGAL^ („� TRUNK PERMIT NO. ROAD PERMIT NO. DESCRIPTION LOT NO. �y AFFIDAVIT I WAIVER EASEMENT RECORD-INSTR.NO. DATE BLOCK TRACT NO,OF BLDGS. SIZE OF LOT & U C tj NOW ON LOT HWY.OR ST.WIDENING USE OF BUILDINGS STATE ENCROACHMENT PERMIT NO. INDUSTRIAL jhr CONTRACTORX WASTE APPROVAL t ADDRESS CHARGES CITY TEL.NO, CONNECTION CHARGE FEE STATE LIC. REIMBURSEMENT FEE LICENSE NO. CLASS O NO. DESCRIPTION OF WORK FEE APPROVALS DATE INSPECTOR'S SIGNATURE V HOUSE SEWER CONNECTING TO PUBLIC SEWER 0 SEPTIC TANK,SEEPAGE PIT OR NEW HOUSE SEWER PITS AND/OR ORAINFIELD CONNECT ADDITIONAL HOUSE SEWER CONNECTING TO BUILDING OR WORK PRIVATE DISPOSAL SYSTEM SEPTIC TANK,SEEP,PIT(S) ' CONNECT ADDITIONAL BLDG. y"� AND/OR DRAINFIE LD 4 W9AK�? QR--MOUSE SEWER ,G L'C-' OVERFLOW SEEPAGE PIT,DRAINFIELD - CESSPOOL El DRYWEIL EXTN_CESSPOOL,DRYWELL,MANHOLE ALTER..REPAIR OR ABANDON HOUSE ALTER.REPAIR,SEWER OR SEWER OR DISPOSAL SYSTEM SEWAGE DISPOSAL SYSTEM DISCONNECT PLUG AND ABANDON HOUSE SEWER BACKFILL SEPTIC TANKS OWNER'S Permit s I SEEP,PIT(S) CESSPOOLS AUTHORIZATION I TOTAL FEE VALIDATION I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NA ED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXI INC DWELLING TOTHE PUBLIC SEWER. SIGNED THIS DAY OF 19 OWNER OR — l_/_X AGENT ADDRESS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS- 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT IAM THE LEGAL OWNER OF,AND INTEND TO RE- SIDE IN.THE ABOVE DE SCRIBED R,sEaSIDENTIAL ROPERTY. SIGNATURE OF PERMITTEE ' fi