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m <br /> ., <br /> -71 <br /> r r- <br /> FC)R OFFICE k - <br /> Ar�aWAnON FM SM*AUW May. <br /> x. <br />......... .,.......,, ................... <br /> .. ...♦ y" .. Permit NOt .}. ».. <br /> .... . Ded . : <br /> P+ it 1 Yew From Dow b"011 <br /> { icetfi .i hereby made to the San Jeaagvin LOW ASCINb D�trlet for a"pertnit.to cirnstr ct and Indo#-d work.tisk <br /> dese ribed.`Tkis q fion Is read# is oar»pli r w t+ty Mrd .' aid er< arses <br /> 4,06 AtCfCAT04 <br /> TGs <br /> ......... <br /> ..... .. ... .... ... r. <br /> .., <br /> 's Nina .. •�,,0 c., s.�,. ...,tiaer► e#��'k�` '!. ... <br /> Ww s+er+n►: Residence�Apartment douse Q cowCorn <br /> - <br /> . <br />_ <br /> - Mote(�fl I <br /> Stere ,,1 <br /> Number erf �-units: Nu6er of <br /> z <br /> �► " °� <br /> ss► �.!.: .... <br /> Water Supply "It Sown and "arse . ..� tart: ,....Ps�r�te <br /> Chwatw of sail to a depil,t _34"t: Sand j]` Silt Q Clay Q Peat U 10*10" Loam 0 <br /> Hardpan 0 Adie 0 ........... <br /> Mat plan, shomrmg side of-lat,"location of system in roam to ry weil ; �. �b+� � at+► re+mru sie�.1 <br /> Ir#Vil Di,Jkli: INo septic tank) ae -pit, :if pubii+t srw+er h hpi!�r ►� ,� <br /> PACKrAE TRSA IIA T ( .l Nl <br /> SEPTIC TANK ...- <br /> 'Capacity <br /> T Ciprlrr <br /> .. . .... .._ •_ IVriahrritsi � #� .�� <br /> Distance to nearest. Well . .. .__ .. .... <br /> Ione <br /> kCNMK� xe <br /> LINE No. of liters „ L of . <br /> V Box Type Filter a O�DejOkJ�, J artetfai .''"' .;, •a...:...:... ` <br /> r " ,Fa tien <br /> bistancwtotiednearestWai � <br /> SEBPA A <br /> .... <br /> PIT '' Depth v - ....., f.. ... . l " <br /> ` <br /> WOW Table Depth ..I t Sin <br /> { <br /> Distends to noorish Weil x0L ' . �...... .. <br /> ►A A, <br /> (Prev. Sanitation Pmt f ............................... `tom <. ......... <br /> 3ep#It T .(Specify Requirefoonta) . µms •.,. r . ;».., ` ...:. <br /> Disposal Field (Specify Requirernents( 0 <br /> ............................................. ....... . <br /> ti <br /> ............. ...... ................. .._.. _....... .. ...... <br /> (DicA aXistift f"Qaddittdn r t � <br /> I'hereby towfv,that I have pr"Wed owNsesr Hire. W" rr� b&6; " ss mo AMMIA 'w ► <br /> ewrtt► Oseiiwrse►c*s, # pe t+�►rt+e, mt 4665 a" a Seer rrr"Ii tl►li Sfire rwnurr fM' il <br /> swi eryenls si0hetwe� �e�s.: <br /> •'I -M the Performienewr.of°the anerk for wrack thls pert Is;ham,I tales s>Nrt miry <br /> MtwsssSios ." <br /> srs ter heeoino subject to Wk's 103 <br /> Signed .:_ ...... . ." <br /> Me -&44464 <br /> f otter than owned. <br /> ARPiiCATIQN ' PTED 8y 9 e D�ETE ��' <br /> BUILDING PERM .. <br /> AWTXX4ALCOMMENTS ................. ...:.,........................... ............_ ... <br /> . ' <br /> .... ...... ........ ...... ... ................ ...._... _............................................................ ... ..... ._• . . ................... <br /> 1p <br /> Final Inspectiots by: .Q11............ ....... .. ., Dot e .x <br /> � <br />`` SAN 1QAQUIN LOCAL AMM-radow <br /> h n <br />