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Home My Public Portal About6304 SALTER AVE_Sewer__ 6A 642Q--rE808--10-71 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ABDoftess6304(7TT� j`L. Salter Ave. LOCALITY Temple City NEAREST FOR APPLICANT TO FILL IN CROSS ST. Longden -, - Ave.--- _ -_LEGAL- --- '41 _�1- - ,p __-__-___ y', DESCRIPTION LOT NO. '. 7 ..+C � OWNER Richard Bowen MAIL MelanieBLOCK TRACT y E jY -�+ ADDRESS 1.620 MlLn. NO. OF BIL GS. SIZE OF LOT F, f�jP_zj NOW ON LOT CITY TEL. NO. USE OF - NGSDISTRICT NO. GROUP MAP PR CESSED BY BUILDI �1 nd• __ _ BK PS CONTRACTOR _. Let-'-I Sewer � -••rJ4��'� � f-�. "�� ADDRESS p293 Maxsn Rd. ` CONNECTION DATA CITY El MonteTEL.TEL. NO. t.I 44-/2Y020 STATION �� ! /' J� DEPTH .1 � LICENSE NO. �.2O J7O CLALIC SS he+ 2 MANHOLE REFERENCE ✓;V >L '� R NO. DESCRIPTION OF WORK FEECONNECT 'R LowER TYPE OF CON NECTI LENGTH FROM P. / 1HOUSE SEWER CONNECTING TO �y Y. CURB M.L.TO P.L. . PUBLIC SEWER @ $7.00 ( 00 SEPTIC TANK,SEEPAGE PIT OR P.C.NO. PITS AND/OR DRAINFIELD @ $10.00 CO.IMP.NO. �' `� JOB NO. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO t' d PRIVATE DISPOSAL SYSTEM @ $3.00 �v "'sv O CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WMYER EASEMENT RECORD.INSTR.NO. DATE V WORK TO HOUSE SEWER $3.00 OVERFLOW SEEPAGE PIT.DRAINFIELD EXTN..CESSPOOL.DRYWELL. 0 $5.00 HWY.OR ST.WIDENING ALTER,REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $3.00 _ STATE ENCROACHMENT W MANHOLE $7.00 PERMIT NO. � a - - - -- - INDUSTRIAL WASTE APPROVAL OWNER'S PERMIT s s ao CHARGES AUTHORIZATION TOTAL FEE 10 .00 CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER_ APPROVALS DATE INS TOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT -- CONNECT ADDITIONAL BUILDING OR WORK ADDRESS _ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK.SEEP,PIT(S) ANO/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY �_-- WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL [:1 DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER.REPAIR,SEWER OR LICENSED AS REQUIRED BV LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM r.AL_IFORN;A OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE DESCRIBED RESIDENT AL PROPERTY. ABANDON HOUSE SEWER SIGNATURE OF PERMITTEE BACKFILL SEP J,C TANKS ❑ -_-- SEEP.PIT(SV ',CESSPOOLS ❑ VALIDATIONCK M,11. CASH 6A 642,D-CE8G8-10-71 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER /�i{ yy;� BUILDING AND SAFETY DIVISION FNEAREST 6304 .1Y• Salter Ave. Temple Qlty FOR APPLICANTTO FILL IN den Ave,LE ; ) DESCRIPTION LOT NO. e/ ,.^_.- ., OWNER Richard Bowen �} MAIL Melanie '{Lyy n BLOCK _ TRACT �`'„ - �� ADDRESS_ 1.620 M . � NO. OF BL GS. SIZE OF LOT Ze$ )L 1(-%5 NOW ON LOT CITY Arnadi aTEL. NO. USE OF BUILDINGS_$e� DISTRICT NO. GROUP I MAP OCESSED BY SK P3 CONTRACTOR e e Ce ADDRESSCONNECTION DATA 2933 Maxsnn Rd. T, '1 Af( STATION �"��/ �" DEPTH ,. CITY L'y'1-1'i0-�t�.j TEL. NO. /f ✓��p r LCENSE N0. nQ(] }°�TA LIC CLASS^ MANHOLE REFERENCE y' tt ,�� 1.288'ja �0 f yry-t � LOWER NO, DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM �--/�y HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L,TO P.L. PUBLIC SEWER 0 $7.00 -- SEPTIC TANK,SEEPAGE PIT OR CO. IMP.NO. I .,_ JOB NOP.C.NO, - . - PITS AND/OR GRAINFIELD � $ip.00 _ } HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. 'Y PRIVATE DISPOSAL SYSTEM @ $3.00 ij-�1 O CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIVER EASEN¢NT RECORD. INSTR.NO. DATE V WORK TO HOUSE SEWER 0 $3.00 OVERFLOW SEEPAGE PIT.DRAINFIELD _ fly EXTN..CESSPOOL.DRYWELL. $5.00 O ALTER,REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING -- (� SEWER OR DISPOSAL SYSTEM @ $3.00 _ STATE ENCROACHMENT W MANHOLE-----_-_ $7.00 PERMIT NO. �„/ - 0- _ - --- INDUSTRIAL N 'IWASTE APPROVAL OWNER'S PERMIT s CHARGES AUTHORIZATION TOTAL FEE 30 , 00 CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTORTO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING — TO THE PUBLIC SEWER- APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19 -- OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL ADDRESS BUILDING OR WORK _ SEPTIC TANK,SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR GRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY -- _-. WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CE55POOL ❑ DRYWELL 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSED AS REOU IRED BV LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER QF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE DESCRIBED RESIOENTI PROPERTY. ABANDON HOUSE SEWER SIGNATURE OF PERMITTEE —b "�!��" - BACKFILL SEPTIC TANKS ❑ SEEP.PIT IS) ❑ CESSPOOLS ❑ VALIDATION d CK. M.0. CASH 5 �: