pr ,3 .. .s- - - Ra. •y: L -
<br /> v •U��'3 h.lj7rna�scl�,ilt - ' ', 'I
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<br /> F ILE
<br /> FQ^'QFFIC-.. LiS',
<br /> APPL1GATiON FOR S�aNI ATiON PERMIT 1� -
<br /> (complete in Triplicare) or lvwrl f }
<br /> +, �:
<br /> This Pormit Expire+ 1 Year From Dais lstu*d .t
<br /> r 49 and Pp
<br /> Af"ti;nhl�r�l y mLtrfn I ,n t STplllrancP Wil�
<br /> phron Icit to
<br /> h CUuoyt5
<br /> torOrdinalrjrnC.a ItJOm5 r.,-,'llni3 R,II t}rdn'{thre �Ulation+tl
<br /> ;el
<br /> drfsLril+nrl This applitnllon
<br /> /t•f`t+_ Ct �tii.0 U ( . P!.CT A ,7
<br /> JOB ADDRESS/LQCATIQrd i'r `-
<br /> 4i
<br /> t .
<br /> C)wnrr's Nor,r:
<br /> City L {? a
<br /> Addrrss / F s t,enr 7
<br /> C,�srlt��rtar.;.•;,CJcs-r1.,s•- .�. .„ -•. .,� �.•; .,._ . .. . „ ,., .,. I s� - . . �'��'
<br /> *real Tv)der Cct
<br /> Instoilotion will !.erve.
<br /> ApartInrn't ► 0;use[ 1 Co r1
<br /> r-totrl r�Other C7v.►.t,�a. ""[. -M / I
<br /> of bedrooms Gorbage Grinder �, f
<br /> Number of living units: , g
<br /> trva'e -<'t
<br /> Water Svppiy. Public Sy,sen, nr: . nt,mn a is{'
<br /> r-cit Sanely l.oct-, `. Clay Loom iM
<br /> Chaecctrr cf soil to a elcpth c•f 1 (•'r'' Sons}} Silt[] Cloy ❑
<br /> rl pain rl Adobe Fill Matcriol if yes,
<br /> n:. . ;
<br /> {Plot plan, showing size Of Ie' ta�nrlcn of system in relatic,n to wells, buildings, etc. mutt he nlacrcE on reverse side.t
<br /> NEW INSTALLATION: INIo ;,,�t•� tangy o, srcpnge pit,perertitted if public sewer is ovoilab4� within 2Q0 feet.] k r„ i.i •
<br /> SF"T1+= i MIK , Liquid Depth V
<br /> PACKAGE TREATMENT I ]' t Size 4 a,
<br /> J;ldterial Nn. Compartments
<br /> copoc,!r Type
<br /> ' rf
<br /> t pLJnr+t]lian Fro(,. 1.lnr'
<br /> Length
<br /> of each line Wpll
<br /> lotnl eng}h
<br /> LEACHING LINE ] ] TJn. n,4 I.enr:
<br /> L,. fit, Tti Filter,;Mgtefigl k Depth Filter. Motrrint x I t
<br /> _ �LtWr § �' L ! i-
<br /> t _ Lrirr � gni .�a� s�l.! .6 i'r l+t7�th -l;�t'yv` x. It +h:. n I L
<br /> zs i},, ' ler^,+ E pu., s - ' - •I - r '1, I x I Y
<br /> �t,aat a ar ,�" � �ttr+tl c` R `r4 c14ied Yc, [ Nod[; +
<br /> SpEPAC'E p1T ''{ s fJ' till, p,c+meter#x H
<br /> ara I:rs � tisY A
<br /> C)cpth � F �+ 4ZbClc Sf2@ i cr f
<br /> Fovndat+o+� Prop. Line xT
<br /> WfIll t. f k
<br /> Dole , F
<br /> SEPAIR/ADDI110NIPrr.v Ss:nite'Inn Pcrmlt ' t'r
<br /> 1iV74� f 4 4 F
<br /> Sx'ptic Tank:tsoccify F`.on.il;n. �
<br /> ..yy
<br /> nr r 'cr �sc� .
<br /> Ier" MI�f3lll!17•�' ,ttt k } �. a,. is
<br /> ��I3iSl 0541+-l=Leld J5p y
<br /> s r'I
<br /> Iti r.N lr A.�ibLi •fit
<br /> �.� t`a�,�•. tri ! r r v1£ s r IJrn,N hV'stIng i7nd r@(YCalrCll-(1C�1y1tiL,h On fCYCrSC Si[tei
<br /> I "`' i+egt+en '!+he� that the work will b�
<br /> dome ir. actordaata with Son' Jaagylri
<br /> ''1 h 'ieb; certify iurLt t ha p ,rtrrd this aPP rf i:
<br /> t
<br /> Iii
<br /> ' CotJn►y r�rdf 4antts 'Stat« t._ snc!, kuics and ilegult}grins a#=,thi,' ' Joaquin total tiwal+i, I7isrr;ct, (tam• awhw er:,{fi eri- 41.
<br /> sed ag4nts trgnature"tcrrifio, ft)-! }cllawing: ?+r`4' } Iii ; ' Person in SU is ,-
<br /> pissued, 1 +hall not employ any P l' I n ]:t
<br /> certiFy ihpf it, the.pFrforr ycr•cc of the work for vlfWeN tlsllr erini x
<br /> as becaene'iubject to W� kr- n', Cnmpensatinn'Iaw� o�IC�li� ►i►#n t� j:
<br /> Lr{tiH rTf,(y• ij rLN
<br /> !,Owner
<br /> SlpnrGi 1 �
<br /> By
<br /> r � 9
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<br /> llf,� 1[•r tl,i,., r;n' I � �°� '�° 5`� '� � �FIK � ��1 #l':
<br /> I/ FO D Mfl€' USE
<br /> Ir�yT E I ONLY
<br /> "
<br /> f4.PPlit"A7113fJ A t:t�f ORIF i
<br />:'] {}lf.�lJ Jr"r i?(V,'i`f I':r♦'J: _ r.�UJ'�;.i31 ,,tr z. I ,. +� r i x.
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