Laserfiche WebLink
1l, Who( Is the depth to groandwalerl <br />Unknown <br />Oescrlbe the source or Informntlon: <br />13. Are there any water wells on this parcel or adjacent proporllesy <br />YES JN NO I 1 <br />TYPF, OP wlrl lS I MSYANCR TO <br />Public Well n <br />private Well O n" <br />Irrigation Wen n' <br />well I n• <br />Other I It. <br />14, Will the intik(s) pending closure be replaced Olt an aboveground or underground storage tank(W YES( 1 NOK <br />15. tndltale the reeponslble pntty to be billed for additional pll$-EIID Starr time expended beyond <br />e , pram 1�mouummEr' <br />permit payment per Intik. It the party designated below Is di(rerenl than the permit app <br />the party must acknowledge this responsiblilty for rhe billhog by signature and date below. <br />Name Jefferson ELementar 8 01 D <br />Ninlling Address 7500 W..Linn Road Trac CA <br />Uny phone Number ( 209 ) 836-3388 <br />D <br />I)ote <br />Page 6 <br />