HomeMy Public PortalAbout9559 WOODRUFF AVE_Sewer__ • s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ; SE 0508 9706230006+
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (.818) 285-0488 EXT: -- LEGAL --
SE P C: S DING ADDR SS:,
TR: 6561 LT: 257 EXIST OCC GRP: 9559 WOODRUFF AV
BLDGS. NOW ON LOT: MP CA 917802043
ASSESSOR IN0 CONNECTION TYPE: tCEAREST CROSS ST(NT:
5385-013-011 ORIGINATION: THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED . PROCESSED B 0 :
06/23/97 TC 06/
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FI ALB CODE:
WONG, JESSE (213) 222-8929- JOB NUMBER:
9559 WOODRUFF AV TRUNK PERMIT NUMBER: '
yu—
TEMP 917802043 ROAD PERMIT NUMBER: DESUFIPTIDN
AFFADAVIT: NO CONNECT REMODELED HOUSE TO HOU E EWER
WAIVER: NO
APPLICANT: TE . NO: EASEMENT: NO
AMERICAN TECH CONS. (213) 222-8929-
RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREET WIDENING:-
STATE ENCROACHMENT PERMIT NUMBER:
CONTRACTOR: TEL. NO: FEES PAID APPROVALS DATE INSPECTOR SIG ATURE
AMERICAN TECH CONSTRUCTION (213) 222-8929-
130 E. AVE 32 LIC. NO FEE DESCRIPTION: -QUANTITY: UOM: AMOUNT: NEW HOUSESEWER )7���
LOS ANGELES, CA 90031 013107
01 PERMIT ISSUANCE FEE 27.75 CONNECT ADDITIO A
15 ALT/REP HOUSE. SEWER 1.00 'EAC 30.30 BUILDING OR WORK
ARCHITECTOR ENGINEER: -TEL. N0: TOTAL FEES 58.05
- SEPTIC TANK, SEEPAGE PIT
LIC. NO: AND/OR DRAIN FIELD
D _
SEWER MAP BOOK: PAGE: ALTER, REPAIR, SEWER OR
SEWAGE DISPOSAL SYSTEM
SCO C P G
ABANDON HOUSE SEWER
BACKFILLSUP-MC-TANS—
SEEP.
P C SSEEP. PIT CESSPOOL
GRAYWATER SYSTEM
I
* ADDITIONAL DATA ON FILE
REPORT ID: DPR266 ROUTE TO BS0508
i
T6^ -66B 11.98
E APPLICATION FOR PERMIT
3& .BB
DIVISION OF BUILDING AND SAFETY SEINER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles ADDRESS NG
ADORE
AS
JOHN A, LAMBIE, COUNTY ENGINEER -- ---J°--- �- �
CASSATT E)- GRIFFIN. SUPT Or SUILDINI, LOCALIT7'_�„d/.r�-�s��p°'`„��-
NEAREST
FOR APPLICANT TO FILL IN ceo5s ST � --
LEGAL ...- .r. ?T N
N LOT OWNER - w�` .a`'°'-a".✓ d' ;..d'.wr,,.��„” T
QRIPT OOO ,,� _..
_..._ �t-�L' ..%}'��—.--�"ac Vie'`
BLOCK 4 TRACT �;f MAIL
f ADDRESS
----- ^+,^.rte- ------------._-_-_._-_._-
SIZE OF LOT ----------'----------- ----
NO.OF BLDGS.
_ __ CITY TEL. NO.
!` � NOW ON
USE OF
JUILD NGS_. _g. '�s" _,r�`.�✓s}4w..-- -- -- DISTRICT NO. i GROUPI MAP
BK PG
CONTRACTOR/
e'
ADORES~ CONNECTION DATA
"D STATION
&E L NO .✓ ,s,,,r y UPPER
MANHOLE REFERENCE -� `-
- y f
C 'fATE
REGISTRATION NO. f - u COUNTY - -
No DESCRIPTION OF WORK FEE — — --- - ----
-� - - ----- - ---- --- TYPE OF -e" 'CTION - LENGTH FROM
H.
HOUGSEWER CONNECTING TO �`'
r✓' I .: Y. S'CURB✓ P.L, M.L. "f0 P,L...
PUBLIC:>CWcR (�+� $3..5')� I —. ._"�---"----------
1 -.._- - - --- ----. ..
SEPTIC TANK,SEEPAGE PIT OR ?
PITS AND/OR DRAINFIELD $_3.&'0__ -- --- -- __ —_--- — ---_--
I OVERFLOW SEEPAGE PIT,DR.AINFIELD � P C. NO. -
EXTN..CESSPOOL,DRYWELL,NANHOLE (&e, $Z.GOCO, IMP. NO, �✓ % ✓ `. � ;OB NO.
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM (d. $S.OG TRUNK PERMIT NO. ROAD PERMIT NO.
CONNECT ADDITIONAL BLDGOR STATE ENCROACHMENT
_WORK TO HOUSE SEWER {(i' .$I.GC j PERMIT NO,
ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DI POSAL SYSTEM fir._�1 G WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT S 00 ---- — _-- -------- --– ---
---- - - REIMBURSEMENT FEE
AUTHORIZATION TOTAL FEE -: e
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS j DATE INSPECTOR$S'GNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEW-ER, NEW HOUSE SEWER I I
SIGNED THIS 'F DAY OF_ �✓ ly ------, I - ---
�— � � ---:�- CONNECT AD WORK OWNER OR BUILDING OR WORK. � — -.-.-_-
..OWNERS AGENY r r < Vie_ ;,1- '' - SEPTIC TANK,SEEP,PIT(S) - --....
ADDRESS �x � �-''`�! -� ,'r"��ll�/� -' AND/OR CRA1NFiELQ
I HEREBY ACKNOWLEDG THAI I HAVE READ THIS APPLICATION Cc55P00+.❑ URYWELL[]
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR ILII
PLUMBING AND SE1VERS. SEWAGE DISPOSAL.SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/CR WSCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER !
CALIFORNIA ORTHAT i M THE LEGAL 0 OF, THE ABOVE - —
DESCRIBED RESIDENII OpERTY. },� ") 'y BACKFILL SEPTIC TANKS[I
SIGNATURE ' - / SEEP.PI (S) L_I CESSPOOLS
FI -
.f -— --- - --_-'-_-----
OF PERMITTEE. ��
i
1OHN A. LAMB IEi OUNTlY ENGINEER VALIDATION_ ROBERT A.WOOD,CHIEF PLBG. '1N'SPECTOR