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Home My Public Portal About5120 FARAGO AVE_Sewer__ T"64zo. APPLICATIONFOR PERMIT' 1 5&E.863 11.55 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Deportment of County Engineer County of Los Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ® CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST ROS,s. LEGAL OWNER DESCRIPTION LOT N0. MAIL BLOCK f3 TRACT - ` 7— ADDRESS ,g ' N0. OFOBLDGS. SIZE OF LOT wen NOW NLOT *, DISTRICT Y BUILDINGSTEL. NO �� USE OF NO. GROUP MAP K G CONTRACTOR 62 r co r�� ] / CONNECTION DATA 6 `- ADDRESS CITY a.��a TEL. N0. ® �' STATION 8 DEPTH kG`^ s MANHOLEREFERENCE (r TE r i LOWER REGISTRATION NO. ( ,� COUNTY No. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNECTI LENGTH FROM asy CURB P. M.L. TO P.L. 1 PUBLIC SEWER @ $3.50 SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD CO. IMP. NO. / JOB NO. EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.00 -. TRUNK PERMIT NO. ROAD PERMIT NO. _ CONNECT ADDITIONAL BLDG.ORf STATE ENCROACHMENT WORK TO HOUSE SEWER @ $1.00 a PERMIT NO. ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL i. SEWER OR DISPOSAL SYSTEM @ $1.00 WASTE APPROVAL CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT 1 00 REIMBURSEMENT FEE AUTHORIZATION TOTAL FEE f I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- ` APPROVALSDATE INSPECTOR'S SIGNATURE z TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER _ Cf SIGNED THIS—DAX OF 1 CONNECT ADDITIONAL / OWNER OR BUILDING OR WORK OWNERS AGENT SEPTIC TANK,SEEP,PITS) . ADDRESS AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APP64ATION '' CESSPOOL❑ DRYWELL❑ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ''. ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF =; ABANDON HOUSE SEWER CALIFORNIA OR THAT I A THE LEGAL NER OF THE ABOVE DESCRIBED RESIDENTIAL OPERTY. BACKFILL SEPTIC TANKS❑ SIGNATURE _ � SEEP.PITS) 0 CESSPOOLS❑ OF PERMITTEE n ' JOHN A. LAMBIE. CO• TY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR CK. 61.0. CASH :. 798MR AN 30 4 A 5-50 �' [47HFLE QTV CES08za_59 APPLICATION FOR PERMIT —o 1 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL + DEPARTMENT OF COUNTY ENGINEER :3,!�PAP BUILDING AND SAFETY DIVISION BUILDING =,ems �/ � JOHN A. LAMBIE, County Engineer ADDRESS i� CASSATT D. GRIFFIN, Sup t of Building LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL DESCRIPTION LOT NO. OWNER BLOCK TRACT MAIL ADDRESS NO.OF BLDGS. SIZE OF LOT NOW ON LOT CITY !TEL.USE OF DIBUILDINGS a • DISTRICT N0. GROU /� MAP �CESSFp BY CONTRACTOR /MBK /— I / ,�// ADDRESS - CONNECTION DATA CITY TEL.N0. �� ONS ®r DEPTH ❑ STATE MANHOLE REFERENCE REGISTRATION NO. ❑ COUNTY – NO. 1 DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO6-0 PUBLIC SEWER @ $3.00 TYPE OF CONNECTION LENGTH FROM . SEPTIC TANK,SEEPAGE PIT OR Y. CU'RB P.L. M.L.TO P.L. L' PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT.DRAINFIELD EXTN..CESSPOOL.DRYWELL @ $2.00 HOUSE SEWER CONNECTING TO P.C.N0. PRIVATE DISPOSAL SYSTEM@ $1.00 CO.IMP. NO. - 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 DISPOS L SYSTEM @ $1.00 PERMIT N0. INDUSTRIAL WASTE APPROVAL (.. CHARGES OWNER'S PERMIT 51 21 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVE AT DATE A CONTRACTu TRACTOR TO CIONNECT THE ABOVE E1SCR BED EXISTTHE IINGAMED DWELLING APPROVALS DATE INSP CTOR'S SIGNATURE TO THE PUBLIC SEWER. pp y SIGNED THIS DAY OF 19— NEW HOUSE SEWER �N '(q �= OWNER OR CONNECT ADDITIONAL `• OWNERS AGENT' BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP.PIT(S) a, AND/OR DRAINFIELD I 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 ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. i SEWAGE DISPOSAL SYSTEM I 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 T T I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED OR T L PROPERTY. B CKFILL SEPTIC TANKS ❑ SIGNATURE EP.PIT(S) SSPOOLS OF PERMITTEE ®P VALIROBERT A. WOOD CK. td.O. CASH SUPERVISING MECHANICAL. ENGINED �� , 7SA64t. APPLICATION FOR PERM I ! _-57-�6 CE808 a-50 COUNTY OF LOS ANGELES ® SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS JOHN A. LAMBIE, County Engineer CASSATT D. GRIFFIN, Supt of Building LOCALITY _..., - .. _. NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL DESCRIPTION LOT NO. OWNER BLOCK TRACT _ MAIL ADDRESS NO.OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL. N0. USE OF BUILDINGS DISTRICT NO. GRO UP g'�• MAP .PROLES BY / z— CONTRACTOR 01 0 �'' c� cJ /l I \✓ ADDRESS ® CONNECTI N DATA CITY TEL.NO.J_,, 4,,p ATION �, DEPTH r STATE MANHOLE REFERENCE`S REGISTRATION NO. ® p ❑ COUNTY LOWER NO. DESCRIPT ON OF WORK fEE l HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3.00 TYPE OF CONNECTIONENGTH FROM SEPTIC TANK,SEEPAGE PIT OR Y. CURB P.L. M.L.TO P.L. PITS AND/OR DRAINFIELD @ S3.00 OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN..CESSPOOL.DRYWELL @ S2.00 HOUSE SEWER CONNECTING TO P.C.NO. PRIVATE DISPOSAL SYSTEM @ $1.00 CO. IMP. NO. JOB N0. WORK CT ADDITIOUSE EWER BLDG.OR @ g1 00 TRUNK PERMIT NO. ROAD PERMIT N0. S ALTER,REPAIR OR ABANDON HOUSE STATE ENCROACHMENT SEWER OR DISPOSAL SYSTEM $1.00 PERMIT NO. OMIINDUSTRIAL ad WASTE APPROVAL CHARGES Q R'$ I PERMIT g CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE NAMED CN- TRACTOR TO CIONNECT THE ABOVE DESCRIBED EXIISTDATE A CONTRACT WITH THE IING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. SIGNED THIS DAY OF 19_ NEW HOUSE SEWER OWNER OR /'$gyp CONNECT ADDITIONAL OWNERS AGENT/ BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP.PIT(S) AND/OR DRAINFIELD 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 ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. 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 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENT L ROPERTY. BACKFILL SEPTIC TANKS ❑ P.PITS [IESSP S ❑ SIGNATURE OF PERMITTE ®p VALIDATION ROBERT A. WOOD CL te.o. CASH SUPERVISING MECHANICAL ENGINEER G SEP 6m—