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FOR OFFICE USE <br /> FOR CIFFICE USE APIPUCAT10N PM SAWTAYMN PERMIT I <br /> I 1 Permit No../727' OX;77.7 <br /> r <br /> t{grtlpMto itt T.iPliosMl ` i <br /> This Penak Exotw T Yew From Dose lsawd <br /> Construct and instal olio work herons detaibtd. <br /> Applkolian is he+eu, <br /> bY made to the Son Joaqn 10`01 Heahh District for o Pei mit to <br /> with Covnry Ord nonce,No 549 and ex'sl,nq RJ and Regulations' <br /> This opµlcataan •s made'n compliance <br /> ag�sry CENSUS TRACT t <br /> JOB ADDRESS. <br /> AaDRESS.'tQTOfy r • + j .'.(e,/G,� , ` 7hand <br /> Gtg o"mer JI/Z/iGp <br /> Addeest <br /> l <br /> Contractor s tisorot <br /> snstollation will serversrt <br /> : Rosrrdenco + Apmem Hose Comm"-`.ai J Tralfer Court �1 i <br /> Motel L 1 Other <br /> Nu`Irber Of I1v,-9 units / Number of bedroom% .Garboge Onrid r Lot Size Ot <br /> Prrvntc <br /> Wo•e,Supply. Pvbl,c System and name ,..z <br /> Character of sort to a depth of 3 fort- Aond-L 5=7: Clay'7I Pea' 'j Sonat lam"' L� Clay :Darn <br /> p/ <br /> HOtdpan IJ Adobe �:, Flh Mgteiipl If yes,rY-pe. <br /> • Plan, s'" sy t �Wells, <br /> .e T, , nqs.arc must ac placed on rweru %.de I � <br /> IPtat plan, thawing rxe of io+, lacat+on of system m rofotton o we.ls h� ids / <br /> NEW INSTALLATION: :Nsa seP"c tan% or uep a p,t oerm.tled �f p '�so�ve'_s_arp loole within 260 ?het; C/ <br /> Size Y S7. 009 L acid Depth : a� _ ` ` <br /> I PACKAGE TREATMEN' 1 SEPTIC TANK //ter /� , <br /> Copocity/dR0O No Comportmems <br /> Fovnda -7 r <br /> r / Prop Live 175 <br /> D.stonco to nearest. WWel t-on <br /> t r <br /> Length of-tach tine 7o r0'.Via' Total Leith /0.4r) <br /> EACOING LINE ;Q0 No_ a- Lines ^9c+ la '�—-- A""' Q G pili Fi!tr Motena: /(:g <br /> D' pyxType Fdter Motertolt7/ Foundot,on Qi Q Property LineDistance MCntr�rast Wel I �d.Q De m t7 J Diomaler Nvmberij Rock F,Iled Vas <br /> t SEEPAGE PIT IL✓ P <br /> F Rock Siren � <br /> ' WoMrtobleDepth <br /> /Qty y - � �7t ♦ <br /> r t , Distance to nearest Well <br /> FOvndOtwin S� . Prep :,no../s� /r�'r� <br /> Dote 1 <br /> 2§PAIRiAp♦NTION (Prtry $nniraton Pernit d r <br /> Sepi-c Took lSpocify Regv+rome`$! - 1 <br /> Disposal Feld lSpecrfy Regwremsnal _ a f <br /> 1 f ;nraw exisr+nq ono •eauifed add-trOn on reverse %idol <br /> 1 hereby tertlfir that I have Prepared this application and shat the work will bi dam in oaerdancr with Son loaq+t,n Cewnty <br /> ' e of she Son /oagwle lotol FleaNh District. Home owner or licensed agents <br /> Ordinances. Statlaws, and Roles and Regulations <br /> 1 signaWre codifier the following: + <br /> "I certify that in the Perfortrics"o of the work for which this permit is Issued. l' +holt net "."Play any person In tech mann"' w <br /> to becenu j� to W an s C906 easatkon laws of California.'. - - <br /> - 1i (}wr tv <br /> S,Qreii <br /> 6y • <br /> ' I'f ether than nerl <br /> FOE DEPARTMENT USE ONLY -DATE <br /> i APf'L!CATION ACCEPTED _ _ - - - - <br /> DATE <br /> DIVISION OF LANDNU.MBER . <br /> ADDITIONAL COMMENTS <br /> Final LnspriN,on bY+ - / -J •s3 lie*: stv r !e r <br /> P4 ,s N SAN JOA N LOCAL flEALT DISTRICT <br />