The URL can be used to link to this page

Home My Public Portal About5124 FARAGO AVE_Sewer__ E808a se Ceaoe APPLICATION FOR PERMIT 1 s 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 Sup t of Building LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST _ LEGAL DESCRIPTION LOT NO OWNER BLOCK TRACT .4J( MAIL ADDRESS NO OF BLDGS �O 7 ` SIZE OF LO NOW ON LOT CITY TEL NO O USE OF BUILDINGS DISTRICT NO GROUP MAP PROCESSED BY CONTRACTOR 1 ,771 G/ ADDRESS -'25 W. Br ant Rd CONNECTION DATA CITY M TEL NO STATION O� DEPTH REGISTRATION NO 16��! 7 ATE MANHOLE REFERENCE 1 UP COUNTY PER NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3 00 TYPE OF CONNECTION LENGTH FROM PETS IC TANK AND/OR DRAINFIELD T OR @ $3 00 Y CURB L• M L TO P L / OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE @ $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 @ $1 00 ALTER REPAIR OR ABANDON SEWER OR DISPOSAL SYSTEM HOUSE @ $1 00 STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNER S S 2100 CONNECTION CHARGE FEE AUTHORIZATION TREIMBURSEMENT FEE T 1 HAVE AT THIS DATE A CONTRACT QT THE HERgEIN NAMED CON APPROVALS DATE INSPECTOR S SIGNATURE TRACTOR TO CONN THE ABOVE DES RIBE EJ ISTING DWELLING TO THE PUBLIC �S ER SIGNED r Y ti 19_ NEW HOUSE SEWER ^'Yd OWNER OECONNECT ADDITIONAL OWNERS A ENT BUILDING OR WORK SEPTICTANK SEEP PIT(S) ADDRESS - 4ND/OR DRAINFIELD _ 1 HEREBY AC NOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATETH T THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL El DRYWELL❑ WITH ALL CO NTY ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR SEWER OR PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM I HEREBY L`ERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIDESCRIBEDAOR RESIDTHAT I MTHE PY LEGAL OWNER OF E ABOVE BACKFILL SEPTIC TANKS 11 �IW p SIGNATURE SEEP PIT(S) ❑ CESSPOOLS OF PERMITT Or V, C,�ATION ROBERT A WOOD cic m o CASH SUPERVISING MECHANICAL ENGINEER 23 7 ri- � n 2 R 5 00 S D CE808 n s� APPLICATION Y ®R PERMIT esoe COUNTY OF LOS ANGELES SEWER=SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUMDING AND SAFETY DIVISION BUILDING ' `•1 r ]rOHN A LAMBIE County En eer ADDRESS - CASSATT D GRIFFIN Sup t of Budding ° LOCALITY FOR APPLICANT TO FILL IN NEAREST LEGAL _ _ P477 -�+ DESCRIPTION LOT NO OWNER BLOCK TRACT MAIL ADDRESS NO 'OF BLDGS SIZE OF LOT NOW ON LOT TMANHOLEREFERENCE TEL NOUSE OFBUILDINGS GROUP MAP CONTRACTOR _ KPG ADDRESS CONNECTION DATA CITY TEL NO DEPTH STATEREGISTRATION NO COUNTY UPPER LOWER NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO 00PUBLIC SEWER @ $33ASEPTIC TANK SEEPAGE PIT OR TION LENGTH FROM PITS AND/OR DRAINFIELD @ $3 00 P L M L TOP L OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE @ $2 00 HOUSE SEWER CONNECTING TO �A' PA-WO PRIVATE DISPOSAL SYSTEM @ $1 00 (T✓ CO IMP NO OB NO CONNECT ADDITIONAL BLDG OR < WORK TO HOUSE SEWER @ $1 00 TRUNK PERMIT NO RO PERMIT NO ALTER REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $1 00 STATE ENCROACH * PERMIT NO INDUSTRIA WASTE AP OVAL CHARGES OWNER S PERMIT $ 00 CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE_ r REIMBURSEMENT FEE CON TRACTOR TO CIONNECT THE ABOVE DESCRIBED EXIISTINGDATE A CONTRACT WITH THE HEREINpMED DWELL NG APPROVALS DATE INSPECTOR S SIGNATURE TO THE PUBLIC SEWER SIGNED THIS DAY OF - 19 NEW HOUSE SEWER ~ OWNER-OR -CONNECTADDITIONAL - �- OWNERS AGENT BUILDING OR WORK J ADDRESS"-- - - - -SEPTICTANK SEEP PIT(S) `AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION s ,,,�7 4 AND STATE THAT THE ABOVE IS CORRECT_AND AGREE TO COMPLY ,CESSPOOL-Q -0RYWELL[:I- WITH-ACC -WITH-ALL COUNTY ORDINANCES AND STATE LAWS EGULATING PLUMBING AND SEWERS ALTER REPAIR SEWER OR - 1 HEREBY CERTIFY'"T "-AM"PROPERLY'R IST RED AND/OR- -SEWAGE DISPOSAL SYSTEM ... �.� LICENSED AS REQUIRE BY L ANGE S CO TY NO STATE OF DISCONNECT PLUG AND CALIFORNIA 0 THA t AME'LEG _p NER F_ HE BOVE ABANDON HOUSE SEWER _ DESCRIBED E SIGNATURE NT kL'PROP BACKFILL SEPTIC TANKS [:1SEEP PIT(S) ❑ CESSPOOLS [I OF PERMIT ®� VALIDATION -ROBERT A WOOD KA o cAsx SUPERVISING MECHANICL ENGINEER - - _ - - - LI&5 8 2-1-u APR 2g--1-&-p--- - -300 - I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS BE 0508 1408110005 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285 0488 EXT LEGAL ID ISEWER / SEPTIC SEWER I BUILDING ADDRESS I ITR 11497 LT 8 BL B (EXIST OCC GRP I 5124 FARAGO AV I I IBLDGS NOW-ON LOT I TEMP CA 917803527 I (ASSESSOR INFORMATION NUMBER ICONNECTION TYPE I NEAREST CROSS STREET I 18574 009 042 (ORIGINATION I THOMAS PAGE 597 GRID D4 LOCALITY TEMPLE CITY CAI I ILENGTH ML TO PL STATION DEPTH ITENANT IMANHOLE REFERENCE UPPER/LOWER (ISSUED ON PROCESSED BY 1 I 1 108/11/14 SR 1 IOOUNTY IMPROVEMENT NUMBER I 1 10WNER TEL NO 1PLAN CHECK NUMBER IF NAL DATE F AL BY CODE 1 IREYES RUBEN A VIRGINIA C (626) 622 7587 IJOB NUMBER f 15124 FARAGO AV ITRUNK PERMIT NUMBER -4 ITEMP 917803527 IROAD PERMIT NUMBER I SC�PTI�OF WORK I IAFFADAVIT NO ISEWER LINE REPAIR I IWAIVER NO I 1 1APPLICANT TEL NO IEASEMENT NO I 1 IRIOS RUDY (626) 858 9284 1 1475 E ARROW HWY IRECORD INSTRUMENT NBR RECORD DATE ISPECIAL CONDITIONS I 1AZUSA CA 91702 IHIGHWAY/STREET WIDENING I I ISTATE ENCROACHMENT PERMIT NUMBER I /� ICONTRACTOR TEL NO I FEES PAID IAPPROV S 1 DATE , INSPECTOR SIGNATURE IRESCUE ROOTER (626) 858 9284 1 1 1475 E ARROW HWY LIC NO IFEE DESCRIPTION QUANTITY DOM AMOUNT INEW HOUSE SEWER I I 1AZUSA CA 91702 765155 1 1 1 1 1 101 PERMIT ISSUANCE FEE 27 80 ICONNECT ADDITIONAL I 1 115 ALT/REP HOUSE SEWER 1 00 EAC 30 50 IBUILDING OR WORK I I I 1ARCHITECT OR ENGINEER TEL NO I TOTAL FEES 58 30 1 I I I LIC NO I ISEPTIC TANK SEEPAGE PITI I I IAND/OR DRAIN FIELD I I 1 IDRYWELL I I I _ I I I SEWER MAP BOOK PAGE I (ALTER REPAIR SEWER OR loll / I/ ISEWAGE DISPOSAL SYSTEM '(/(`�r(' 1 IDISCONNECT PLUG AND 1 1 I I (ABANDON HOUSE SEWER I I I IBACKFILL SEPTIC TANKS 1 1 ISEEP PIT _ CESSPOOL 1 I 1GRAYWATER SYSTEM I I 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I 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