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COUNTY OF IAS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1212100002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: ISEWER / SEPTIC: SEWER I BUILDING ADDRESS: I
ITR: 10898 LT: 19 (EXIST OCC GRP: 1 5336 WELLAND AV 1
I IBLDGS. NOW ON LOT: I TEMP CA 917803507 I
(ASSESSOR INFORMATION NUMBER: (CONNECTION TYPE: I NEAREST CROSS STREET: FREER I
18573-035-021 (ORIGINATION: I THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, Cl
I ILENGTH ML TO PL: STATION: DEPTH: I I
ITENANT: IMANHOLE REFERENCE: UPPER/LOWER: (ISSUED ON: PROCESSED BY: ]
I 1 112/10/12 SR
ICOUNTY IMPROVEMENT NUMBER:
10WNER: TEL. NO: IPLAN CHECK NUMBER: IFI AL FI CODE: 1
1ZHANG, ZHENG YQ (626) 823-3360- IJOB NUMBER: i �eL
5336 WELLAND AV TRUNK PERMIT NUMBER:
TEMP 917803507 IROAD PERMIT NUMBER: IVESCRIPTION OF WORK
JAFFADAVIT- NO ]CONNECT NEW SINGLE FAMILY D LLING TO PUBLIC SEWER
IWAIVER
I I
1APPLICANT: TEL. NO: (EASEMENT: NO ] I
ISAME AS OWNER - I ] I
I RECORD INSTRUMENT NBR: RECORD DATE: ISPECIAL CONDITIONS: I
] HIGHWAY/STREET WIDENING: 1
STATE ENCROACHMENT PERMIT NUMBER:
I
CONTRACTOR: TEL. NO: I FEES PAID 1APPROVALS DATE INSPECTOR SIGNATURE I
SAME AS OWNER - I I 1
LIC. NO IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:INEW HOUSE SEWER ] ]
I 101 PERMIT ISSUANCE FEE 27.80 ICONNECT ADDITIONAL ]
103 CONN TO PUBLIC SEWER 1.00 CON 47.00 IBQILDING OR WORK 1 I 1
(ARCHITECT OR ENGINEER: TEL. NO: I TOTAL FEES 74.80 1 I I 1
1 - I ISEPTIC TANK, SEEPAGE PITI I ]
1 LIC. NO: I 1AND/OR DRAIN FIELD I I I
1 1 IDRYWELL _
SEWER MAP BOOK: PAGE: JALTER, REPAIR, SEWER OR I I I
1 SEWAGE DISPOSAL SYSTEM I 1
I I IDISCONNECT PLUG AND I I
I I 1ABANDON HOUSE SEWER
I I I
1 I IBACKFILL SEPTIC TANKS =I ] 1
I I (SEEP. PIT CESSPOOL
I I 1GRAYWATER SYSTEM ] ] I
I
I I I I 1 I
I I I I I
I I I I I
I I 1 I I I
I
I I I I I I
I IREPORT ID: DPR266 ROUTE TO : BS0508 I 1 I 1
I I I I I I
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0809220004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: ISEWER / SEPTIC: SEWER I BUILDING ADDRESS: 1
ITR: 10898 LT: 19 (EXIST OCC GRP: 1 5336 WELLAND AV
I IBLDGS. NOW ON LOT: ]
I TEMP CA 917803507
(ASSESSOR INFORMATION NUMBER: (CONNECTION TYPE: I NEAREST CROSS STREET: FREER ]
18573-035-021 (ORIGINATION: I THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, Cl
ILENGTH ML TO PL: STATION: DEPTH: I
TENANT: IMANHOLE REFERENCE: UPPER/LOWER: (ISSUED ON: PROCESSED BY: EXPIRES ON: I
I 1 109/22/08 SR 03/21/09
I I
ICOUNTY IMPROVEMENT NUMBER:
(OWNER: TEL. NO: (PLAN CHECK NUMBER: IFINAL DATES BY: CODE: 1
1ZHANG, ZHENG YU (626) 383-0798- IJOB NUMBER: I P- ❑❑I
1I^/'
15336 WELLAND AV [TRUNK PERMIT NUMBER: I 1I I I��
ITEMP 917803507 IROAD PERMIT NUMBER: IDESCRIPTION OF WO I
IAFFADAVIT: NO ICONNECT NEW RESIDENCE TO PUBLIC SEWER 1
IWAIVER: NO
(APPLICANT: TEL. NO: 1EASEMENT: NO
IZHANG (626) 383-0798-
15336 WELLAND AVE (RECORD INSTRUMENT NBR: RECORD DATE: ISPECIAL CONDITIONS:
ITEMPLE CITY CA 91780 HIGHWAY/STREET WIDENING: I I
1 (STATE ENCROACHMENT PERMIT NUMBER: I I
ICONTRACTOR: TEL. NO: I FEES PAID (APPROVALS DATE INSPECTOR SIGNATURE I
IZHENG YU ZHANG (626) 823-3360- 1 1 I
15336 WELLAND AVENUE LIC. NO ]FEE DESCRIPTION: QUANTITY: DOM: AMOUNT:INEW HOUSE SEWER I I I
[TEMPLE CITY, CA 91780 NONE I I ] I [
101 PERMIT ISSUANCE FEE 27.75 ICONNECT ADDITIONAL I I I
103 CONN TO PUBLIC SEWER 1.00 CON 46.95 IBUILDING OR WORK I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 TOTAL FEES 74.70 I I I
I - I ISEPTIC TANK, SEEPAGE PITI I I
LIC. NO: i 1AND/OR DRAIN FIELD I I ]
1DRYWELL
SEWER MAP BOOK: PAGE: 1 (ALTER, REPAIR, SEWER OR ] I ]
I I ISEWAGE DISPOSAL SYSTEM ] I ]
I IDISCONNECT PLUG AND I I I
1 ABANDON HOUSE SEWER
I I I
IBACKFILL SEPTIC TANKS I I I
I I ISEEP. PIT _ CESSPOOL
I I IGRAYWATER SYSTEM
I I I I I I
I I 1 I I I
I I I I ] I
I I ] I I ]
I IREPORT ID: DPR266 ROUTE TO : BS0508 I [ I ]
I I ] I I I