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Home My Public Portal About9426 LEMON AVE_Sewer__ TEMPLE CITY 0-63 76A642D APPLICATION FOR PERMIT 6A642 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS 26 E. Lemon WILLIAM A. JENSEN, Sup't of Building T LOCALITY " � e C 1t1T NEAREST FOR APP ICANT TO FILL IN , CROSS ST LEGAL i DESCRIPTION LOT NO OWNER Euclid MAIL BLOCK TRACT ADDRESS 00 S Garfield. Ave. NO OF SLDGS SIZE OF LOT NOW ON LOT CITY Alhambra TEL NO USE OF BUILDINGS Res. DISTRICT NO GROUP BK MAP PROCESSED BY PG ID CONTRACTOR Sauare Deal Sewer Service ADDRESS 2933 Monte Rd/.'l CONNECTION DATA CITY El P�'l.onte TEL NO GI 4-2020 STATION Y ;j� DEPTH ATE MANHOLE REFERENCES UPPER E3 �xS REGISTRATION NO 128870 ❑ COUNTY NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION LEN FROM HOUSE SEWER CONNECTING TO Y CURB P L M L TO P L d PUBLIC SEWER @ $S 00 0O SEPTIC TANK,SEEPAGE PIT OR P C NO O PITS AND OR DRAINFIELD @ $10 00 I CO IMP NO JOB NO V HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO PRIVATE DISPOSAL SYSTEM @ $3 00 ^ CONNECT ADDITIONAL BLDG OR AFFIDAVIT I WAIVER [ASEM[NT RECORD INSTR NO DATE WORK TO HOUSE SEWER @ $3 00 OVERFLOW SEEPAGE PIT DRAINFIELD W EXTN CESSPOOL,DRYWELL,MANHOLE @ $5 00 HWY OR ST WIDENING H CL ALTER REPAIR OR ABANDON HOUSE Z SEWER OR DISPOSAL SYSTEM 3300 STATE ENCROACHMENT I PERMIT NO INDUSTRIAL WASTE APPROVAL OWNERS PERMIT $ 2 OO CHARGES AUTHORIZATION TOTAL FEE 2 00 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 SEWER APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL ADDRESS BUILDING OR WORK SEPTIC TANK SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL ❑ IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER REPAIR,SEWER OR LICENSEDAS 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 ABOVEDESCRIBED RESIDENTIAL ROP TY ABANDON HOUSE SEWER SIGNATURE O�J•y BACKFILL SEPTIC TANKS T ❑ OF PERMITTEE SEEP,PIS) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD K M o CASH SUPERVISING MECHANICAL ENGINEER _;lt� 1 0 2 7 n('R29 1 0 D 7.00- llo-83 76A642D APPLICATION FOR PERMIT 76A84 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDIN7G , JOHN A. LAMBIE, County Engineer ADDRESWILLIAM A. JENSEN, Sup't of BuildingLOCAL,TNEARESFO T TO CROsS S U(i LEGAL yy__ DESCRIPTION Jr MAIL n BLOCK ! TRACT ADDRESS ,A2 �T NOOF BLDGS SIZE OF LOT NOW CITY ON LOT TEL NO USE OF ' BUILDINGS DISTRICT NO GROUP MAP PROCESSED BY BK PG CONTRACTOR 7C .5 // ADDRESS v (J CONNECTION DATA STATION DEPTH CITY TEL NO STATE MANHOLE REFERENCE UPPER REGISTRATION NO COUNTY LOWER NO DESCRIPTION OFtWORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y CURB P L ML TO P L PUBLIC SEWER @ $S 00 SEPTIC TANK SEEPAGE PIT OR P C NO O PITS AND/OR DRAINFIELD $10 00 CO IMP NO JOB NO V HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO cx PRIVATE DISPOSAL SYSTEM @ $3 00 ^ CONNECT ADDITIONAL BLDG OR AFFIDAVIT WAIVII 1ASrMENT RECORD INSTR NO DATE V` WORK TO HOUSE SEWER @ $300 IV• OVERFLOW SEEPAGE PIT,DRAINFIELD LLI EXTN CESSPOOL,DRYWELL,MANHOLE @ $S 00 ALTER REPAIR OR ABANDON HOUSE HWY OR ST WIDENING SEWER OR DISPOSAL SYSTEM @ $3 00 STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL OWNERCHARGES S PERMIT $ 2 Oo v Cr AUTHORIZATION TOTAL FEE 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 CONNECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TANK SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT 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 ❑ IHEREBY 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 T T I A E LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE A OV ES RIBL;M PROPERTYABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS E]EEP OF PERMITTE ❑ SPIT(S) ❑ CESSPOOLS LIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER K M O CASH I..t'U0 0 7 4 5'12 °R 2 08 1 D 17 1.0 0 A