HomeMy WebLinkAbout3333 BREA CANYON RD (24)R D'490 <' LOS ANGELES COUNTY RO/lD.p PARTt NT • ` ' . r. i`: e'';.. . , '
REv. $/76 1540 ALCAZAR STREET • ' '
LOS ANGELES, CAL FORNIA 90033 ' Plan Check No.
NOTICE OF IMPROVEIIENT Date Filed
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JI Applicant " ' Telephone Na ` ' ' BUILDING & SAF T.Y OFFICEWI • PRINT i. ,
W Address -,•' ,,.,:.,, , ,, ;., {, , • '
J NO. . STREET CITY ZON , ,
i Owner , :' • . ' , • i = Telephorie No. _-i, - . . ;..
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ZI Address ' , , - ,,/, - ;'„ ;:. , ,-- . , . _;.. .
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NO. I STRN;E1' CITY 'LON .
W Use of Building ' r No. of Stories . !-r ,.-- _"
Legal Description of Property: , %%, t' ,') , .'''%',i.' • -'` ' ir`'' ,_,.`.
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mi Lot(s) Block Tract ' -- sY . , ' ' "!-:' ,
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Job Location . ''` - %% .` -' -' No. D ivewaYst,( ) I______ NO. STN,T I'IiONTAGF. FT.
TO E3E FILLED lN BY ROAD DEPART,4fENT)
111PROVEIIL•'\TS '
F.XISTINC CONDITION RF.QUIRE!11ENTS '. .
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Right of way
Curb & Gutter - -
Sidewalk R.D.
DrivewaYs Tho.
Drainage - " .
RE51ARKS:
Road Department Requirements Met _
BUILDING & SAFETY
Date
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WASTFWAlER ' . /1 /'~'
tECLAM TION ' /
BOLID W lTE MAMAOlMEM C O U NTY SA N I TATI O N D I STR I CTS
OF LOS ANGELES COUNTY
1955 Workman Mill Road / Whiitier, Caliiornia
Mailing Address: / P. O. Box 4998, Whitfier, California 90607 WAITER E. GARRISON
Telephone: (2131 699-7411 / From Los Angeles (2131 685-5217 Chief Engineer and General Manoger
APPLICATION FOR SEWER CONNECTION ___ ___ _----- -- "" -
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File No.: - % I ,
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To Be Compleled By Applicant—PLEASE TYPE OR PRINT)
REFER TO INSTRUCTIONS FOR COMPLETING THIS FORM AND FOR MAILING THE APPLICATION MATERIAL AND FEE'PAYMENT
TO THE'DISTRICTS.
Date: ` / 2 &2
PART I
IMONTHI 1o0.Y1 (YEAR)
7. Name of Appticant 'OLrPF'ER SM F:ST:;^I11'S '
2. Address o1 Property 3333 Ersa Cc:::o: &ca, Ljan.o:n I ar, CAlilornta, 4I765
STFEETI (CITY) (STATEI ZIP)
3. Property Located in Sanitation District No.
4. Contact F!arru C. Sclzreq Phone Number. !( Iq )-5j-D
5. Mailing Address F•} z4E0, .7ccvport So3ch, C!., 926v'0
IF DIFFEHEHT FPOM AOOVE) ISTPEETI ICITVI (STATE) ZIP)
6. County Assessor Map 0ook, Page, and Parcel Number..,3.^._-- -8^ -" -a 35-13-i 1
7, Proposed Properry Use: Constrnc a cor.domininm off2cA hut.idin r
8. User Category snd Units of Usage: (Check the appropriate box and provldo the applicable inlormationJ
a. Residential: Single Family Home(s) Number ot Units:
Duplex Triplez Fourptex ) Number:
Five Units or More Number of Units:
Moblle Homo Park Number of Spaces:
Condominium Number of UNts:
b. Commercial: Hotel/Motel Number oi Rooms:
Convalescent Hospital/
Home Tor the Aged / Number of Beds:
Other (Specify): nff_,` Improvement Square Footage:.1, Q- f*. gz'oes
c. Institutionai: Coilege/University Number of Students:
Private Schoal ) Improvement Square Footage:
Church Improvement Squaro Footage:
d. Industrial' All Categories
NOTE: The cannection lee lor an lndustria! discharger will be calculated by thc Oistricts. lNDUSTRIAL OISCHARGERS
SHOULD NOT COMPLETE PART 11 OF THlS FORM. !n addition, a!! indusfrlal discharge s fo be served by thc
County Sanitafron DisUipfs musf obtain a PERMIT FOR INDUSTRlAL WASTEWA7ER DISCNARGE. An lndustrial dis-
charger is one who generally discharges wasfewater liom any producing, manulaetbNng, processing,institutional,
commerciaf, agricu!lural, or other operation where !he wastewater discharged includes significant q antities o!
wastes ol non-human origin. ,
9. Please submit along with this application a copy of the floor plan or subdivision map of the faciiities to 6e connected to the sewer-
age syslem. This is not required if only one single family home is being connecled. Your application cannot be processed without
fhis information.
PART II: FEE CALCULATION FOR RESIDENTIAL, COMMERCIAL, AND INSTITUTIONAL CATEGORIES
1. Find your appropriate unit of usage and connection fee per unit of usage In ihe Connection Fee Scheduie for the District In which
the prope ty1 9prated. The Connection F e shall be calculated as follows:
3,000 ---- X S 20E - --- — _ $ 8657..00
Number of Units of Usage Connection Fee Per Unit of Usage Connection Fee
SPECIAL CFiEDITS (Only if Applicable)
DEMOLITION CREDIT — --
Please refer to the instructions to determine ' 'a'
whether these credits apply and to calculate
the amount o1 each credit. If appiicable these
credits will reduce the amount of Ihe connec- AD VALOREM TAX CREDIT 1 —S __ 1•b•
tion fec due.
f- . . .. . _ . . .. . ., . .
It Less Than Zero, Enter Zero) i $ R F _ n
Connection Fee Due
Please make checks payable to: COUNTY SANITATION DISTRICTS OF LOS ANGELES COUNTY (Do not send cash)
CERTIFICATION
I certily that the inTormation provided In this application is true a`d coErect to the best of /my knowledge.
Harry C. Schrey _ t t:;mt. j(j/j/,.c, i/ ,, f''!t/`--r-'' g/2r?/g2
PPLICANT OR AGENTI (POSITIONI 151GNATUREI ' DwTE)
Please Print) I
For 7sfrtcts' Use Onfy)
COUNTY '
SANITATION ESTRICTS _
Fee Payment Received: Personal Check 7. I,I i 3lf? /.1``Checked by: "" " OS"Rt'.E%, ., /, iC. '-^
Cerlified Check Rec vieedbyApprovedby: J' '
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Amount: $_.IL 1._ Money Order Date: +-- Date;
Floor Plan or Subdivision Map Attached: 1'es No TER E. GAR ltSOfJ
WHITE COPY—COUNTY SANITATION DISTFiICTS OF LOS ANGELES COU ''t rN t• - •^,
YELLOW COPY—WfLI BE RETURNED TO APPLICANT