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Home My Public Portal About5202 FARAGO AVE_Sewer__ DFPARTAIENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J FOX, COUNTY ENGINEER I BUILDDREINSSG AD � FOR APPLICANT TO FILL I9TRUN�K!&RMIT CALITY BUILDING EAREST ADDRESS OSS ST �EvP LOCALITY DISTRICT NO SERIAL NO PERMIT NO NEAREST �n O n s A 3 7 7 a 9 s CROSS ST--V4 �+� RECEIVED BY Ready for Inspection DATE ISSUED OWNERMAIL ADDRESS �'jJL� e t� � USE ZONE OCCUPANCY BK MAP PO CITY TEL.N ?"/(3 I ES CONTRACTOR IMP NO 3 ADDRESS cg/- + NO CITY Gr�.�c -m TEL NO + NO REGISTRATION NO �-7 —C"ec's ROAD PERMIT 8TATE LECAL STATE ENCROACH NT DESCRIPTION LOT NO 6 PERMIT NO BLOCK TRACT 9 INDUSTRIAL WASTE APPROVAL SIZE OF LOT NO OF BLDGS NOW ON C RGES LOT USE —BUILDINGS 1 CONNECTION CHARGE FE _ NO DESCRIPTI N OF WORK FEE REIMBURSEMENT F HOUSE SEWER CONNECTING TO PE PUBLICSEWER @ $ 380 RECEIPT NO I DATE IBY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1 00 110 ALTER OR REPAIR EXISTING DATE B SEWER OR DISPOSAL SYSTEM 1 00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA SEPTIC TANK SEEPAGE PIT OR PITS AND/OR DRAINFIELD 200 STATION DEPTH CESSPOOLDRYWELL I �.�/A MANHOLE REFERENCE SPECIAL CONDITIONS ONLY 200 J' UPPER kGhVA" TYPE OF CONNECTION LENGTH FROM .?j-0 / OWNERS PERMIT $ I 1 00 V— O"A° PL ML TOP L AUTHORIZATION I TOTAL FEE 140 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED , CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR S SIGNATURE DATE DWELLING TO TIJE PUBLIC SEWER SIGNED THIS s DAY OF _ 19S NEW HOUSE SEWER , OWNER OR CONNECT ADDITIONAL OWNERS AGE9_ BUILDING OR WORK SEPTIC TANK SEEP PIT(S) ADDRESS �' _ _ _ _ AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI CESSPOOL[:] DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE, TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR SEWER OR REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS E] �) SEEP PIT(S)� CESSPOOLS SIGNATURE �/`/�/ OF PERMITTEE _ i6A642A 663 i/a3 2� CE808 3 62 76A642D APPLICATION FOR PERMIT A642 COUNTY OF LOS ANGELES SEWER SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A LAMBIE County Engineer ADDRESS G� mfr WILLIAM A JENSEN Sup t of Building LOCALITY 0-1 NEAREST FC,TYJ- OR APPLICANT TO FILL IN CROSS ST ON LOT NO OWNER MAIL TRACT ADDRESS NO OF BLDGS OT NOW ON LOT CITY TEL NO n S K�1/ DISTRICT NO GROUP MAP PROCESSED BY K PG OR f .� /L ))�pp y�/f q CONNECTIO DATA J- A TEL NO /-9v 4041 !f f/ STATION DEPTH ❑ STATE MANHOLE REFERENCE UPPER REGISTRATION NO El COUNTY NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM �. HOUSE SEWER CONNECTING TO Y L ML TO P L 3 O PUBLIC SEWER @ $5 00 PC NO SEPTIC TANK SEEPAGE PIT OR CO IMP NO JOB NO V PITS AND OR DRAINFIELD @ $1000 HOUSE SEWER CONNECTING TO TRU K P ADP RMIT NO PRIVATE DISPOSAL SYSTEM $300 f �- CONNECT ADDITIONAL BLDG OR AFFIDAVI AIME EASEME ECORD INSTR NO DATE WORK TO HOUSE SEWER @ $300 OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE @ $500 ALTER REPAIR OR ABANDON HOUSEHWY OR ST WID SEWER OR DISPOSAL SYSTEM @ $300 STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNER S PERMIT $1 21 Oo AUTHORIZATION TOTAL FEE lye/) CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS DATE INSPECTOR S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT y CONNECT ADDITIONAL ADDRESS BUILDING OR WORK II I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK SEEP PIT(S) AND/OR DRAINFIELD V AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL ❑ 1 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 VSURIBED RESIDENTIAL PROPERTY ABANDON HOUSE SEWER SIGNATURE OF PERMITTEE BACKFILL SEPTIC TANKS ❑ SEEP PIT(5) E] CESSPOOLS ❑ VALIDATIOI�. -1 ROBERT A WOOD (� SUPERVISING MECHANICAL ENGINEER CK M O CASH t A0 2 % 2 7 PR 1 1 0 D 5,0 0- ti