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Home My Public Portal About5025 FARAGO AVE_Sewer__ \ y 760043 62 78A842D APPLICATION FOR PERMIT � u 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 i LOCALITY e NEAREST FOR APPLICANT TO FILL IN CROSS BT LEGAL DESCRIPTION LOT NO OWNER MAIL BLOCK TRACT ADDRESSS0'5 SIZE OF LOT NOWOON LOTS CITY / L+ TEL NO 4rZ �yZ USE OF DISTRICT NO I GROUP MAP PROCESSED BY BUILDINGS BK PG CONTRACTOR ADDRESS CONNECTION DATA CITY TEL NO STATION ) DEPTH STATE LIC MANHOLE REFERENCE UPPER LICENSE NO CLASS LOWER NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION _ LENGTH FROM HOUSE SEWER CONNECTING TO Y CURB P L M L TO P L d PUBLIC SEWER $500 P C NO O SEPTIC TANK SEEPAGE PIT OR CO IMP NO JOB NO U PITS AND/OR DRAINFIELD @ $1000 HOUSE SEWER CONNECTING TO ' PRIVATE DISPOSAL SYSTEM 53 00 TRUNK PERMIT NO ROAD PERMIT NO O CONNECT ADDITIONAL BLDG OR `� AFFIDAVIT wAlv[R eAS EM EMT RECORD IN-51 NO DATE U WORK TO HOUSE SEWER @ $300 Lu OVERFLOW SEEPAGE PIT DRAINFIELD I CL EXTN CESSPOOL DRYWELL MANHOLE @ $500 V) ALTER REPAIR O R ABANDON HOUSE I HWY OR ST WIDENING Z SEWER OR DISPOSAL SYSTEM @ $3 00 STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNER S PERMIT s 2 00 AUTHORIZATION TOTAL FEE OU CONNECTION CHARGE FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC S W , CC APPROVALS DATE INSPECTOR S SIGNATURE SIGNED THIS DAY OF 190 OWNER OR f NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL ADDRESS / �L C/ BUILDING OR WORK SEPTICTANKSEEP PIT(S) I HEREBY ACKNOWLEDGE THA I HAVE READ THIS APPLICATION AND/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 ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER REPAIR SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO DISCONNECT PLUG AND RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMrrTEE ❑ SEEP PIT IS) ❑ CESSPOOLS VALIDATION JACK R ALLEN SUPERVISING MECHANICAL ENGINEER CK M O C H L�� 6522kS SEP123315C0 r TEMPLE CITY I CES068So APPLICATION FOR PERMIT ceeoe a ae COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING7TILN07:j q� ADDRESSCASSATT D OHN A GRIFFIN SuIE p; of Building� LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST LEGALOWNER DESCRIPTION LOT NOBLOCK TRACT MAIL ADDRESS NO OF BLDGSSIZE OF LOT p� NOW ON LOT rHLPE USE OF BUILDINGS .1/Li OUP MAP /// PROCESS BY CONTRACTOR Yt V /P� /ADDRESS : X ONNECTION DATA CITY TEL NO 0 � ly DEPTH STATERENCE REGISTRATION NO COUNTYNo DESCRIP IO OF 0RK FEE ,�� pHOUSE SEWER CONNECTING TO �-fl "vt PUBLIC SEWER @ $3 00 CONNECTION LENGTH FiROMSEPTIC TANK SEEPAGE PIT OR RB P L M L TO P LITS AND/OR DRAINFIELD @ $3 00OVERFLOW SEEPAGE PIT DRAINFIELD XTN CESSPOOL DRYWELL @ $2 00HOUSE SEWER CONNECTING TO ` P C NO PRIVATE DISPOSAL SYSTEM @ $1 00 —�+� JOB NO CONNECT ADDITIONAL BLDG OR TRUNK PERMIT NO ROAD PERMIT NO WORK TO HOUSE SEWER @ $1 00 ALTER REPAIR OR ABANDON HOUSE STATE ENCROACHMENT SEWER OR DISPOSAL SYSTEM @ $1 00 PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT 2 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE TNAMED CN RACTOR TO CONNECT THE ABOVE HAVE AT THIS DATE A CONTRACT DESCRIBED EXISTWITH THE IJNG DWELLING APPROVALS DATE INSPECTOR S SIGNATURE TO THE PUBLIC SEWER SIGNED THIS DAY OF 19— NEW HOUSE SEWER ° OWNER OR �)/) CONNECT ADDITIONAL w OWNERS AGENT_e�J� BUILDING OR WORK ADDRESS SEPTIC TANK SEEP PIT(S) AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL ❑ DRYWELL ❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR SEWER OR PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM I EHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICNSED AS REQUIRED BY LOS ANGELES COUNTY AND STADISCON TE OF DISCONABANDON HOUSE SEWER CALIFORNIA OR THAT 1 A THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTktL P PERTY BACKFILL SEPTIC TANKS Cl SIGNATURE SUP PITS) CESSPOOLS OF PERMITTEE OF VALIDATIOP�, ' ROBERT A WOOD CL g 0 �gR / SUPERVISING MECHANICAL ENGINEER '— F�0 3 00 500 4 ' TEMPLE CITY 7 o CE808 8B APPLICATION FOR PERMIT E808 8 8 � 7 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL. 1 DEPARTMENT OF COUNTY ENGINEER BUMDING AND SAFETY DIVISION BUILDING D JOHN A LAMBIE County Engineer ADDRESS CASSATf D GRIFFIN Supt of Building LOCALITY C� NEAREST FOR APPLICANT TO FILL IN CROSS ST LEGAL DESCRIPTION LOT NO OWNER BLOCK TRACT MAIL ADDRESS NO 0 BLD S SIZE OF LOT NOW ON LOT CITY TEL NO USE OF BUILDINGS �v DISTRICT NO GROUP MAP PROCES D BY ` IK PG CONTRACTOR a t Q, ADDRESS r--- 5 CONNECTION ATA CITY TEL J. 4AON DEPTH �y STATE MANHOLE REFERENCE REGISTRATION NO A / ® COUNTY LOWER No DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3 00 SEPTIC TANK SEEPAGE PIT OR TYPE OF CONNECTION LENGTH L. M; PITS AND/OR DRAINFIELD @ $3 00 Y CURB P L M L TO P L OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL @ $2 00 HOUSE SEWER CONNECTING TO P C NO PRIVATE DISPOSAL SYSTEM @ $1 00 CO IMP NO JOB NO CONNECT ADDITIONAL BLDG OR TRUNK PERMIT NO ROAD PERMIT NO WORK TO HOUSE SEWER @ $100 ALTER REPAIR OR ABANDON HOUSE STATE ENCROACHMENT SEWER DIS" SAL S TEM @ $1 00 PERMIT NO 1` INDUSTRIAL WASTE APPROVAL CHARGES OWNER S PERMIT $ CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR S SIGNATURE TO THE PUBLIC SEWER p SIGNED THIS DAY OF 19NEW HOUSE SEWER hR OWNER OR CONNECT ADDITIONAL OWNERS AGENTBUILDING OR WORK I ADDRESS SEPTICAND/ORTANK DRAINFEEP PIT(S) DRAINFIELD ♦A 6Y� _�(" 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL ❑ DRYWELL ❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS ALTER REPAIR SEWER OR I I SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDE 1 PROPERTY BACKFILL SEPTIC TANKS ❑ SIGNATURE SE PIT(S ❑ CESSPOOLS ❑ OF PERMITTE ®r VALIDATIOD ROBERT A WOOD CIL H 0 CASH SUPERVISING MECHANICAL ENGINEER LL. 0 5 6 9 JAtd 3 1 1 D 2 5 C U '0 �5441'11LI r