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siGNED Cevx.,24 DATE 6.-2-97 PLOT PLAN [DANN TO SCALE? SCALE NAMES OF STREETS OR ROADS NEAREST TO OR BOUNDING THE PROPERTY OUTUNE OF THE PROPERTY, WITH DIMENSIONS AND NORTH DIRECTION. ONAENNONED OUTLINES AND LocAlloN OF ALL EXISTING AND ppoposEn sTRucTuRLD, wcwooma COVERED AREAS SIKH AS PATIOS, DRIVEWAYS. AND WALATI 2.4.2 6.-.• A p. -3tvx -ii-ta--le.4e44=arsitgeforgit. . 4. LOCATION OF HOUSE SAVAGE DISPOSAL SYSTEM OR PROPOSED EXPANSION oF sEWAGE DISPOSAL SYSTEMS, S. LOCATION of WELLS WirTHIN RADIUS OF ONE HUNDRED FIFTY FT, ON THE PRoPERTY OR ALLICEPAND PROPERTY. PAYMENT RECEIVED..- . i • 1..e. t.V r) 7 . ENvator4a3.i.4,..i4L4...i.i.itovi;;IoN Ia er4I.0.16.-F 0044 SC- ves3 G/Ole,12_. 1 SAN JOADUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION P.O. BOX 388, 304 EAST WEBER AVENUE, STOCKTON, CA 35201-388 12041 40R.3420 NON•REFURDABLE PERMIT EXPIRES I YEAR ROM OAT/ ISSUED ItemsIsta Is Trip APPLICATION IS HEREBY MADE TO THE SAN JOAQUIN COUNre FOR A puthirr TO CONSTRUCT ANDIOR INSTALL THE WWI< DESCRIBED, THIS APPLCATION IS MADE IN COMPUANCE WITH SAN RUMEN COUNTY DEVELOPMENT TITLE, CHAPTER B.1 110.3 AND TNE STANDARDS OF SAN JO 509.1N COUNT, MARIE HEALTH 5€ (I. E.NVIIIONANNTAL HEALTH WNW /2de JOB ADDRESS/DR 01151 4/52 3 PITY RHONE (-TE2 7 4C °INNER'S NASA TDP-.7.- ME I. 'D -70 AnDREss 4,-;* ALI BIL.0 LOT SIZE CONTRACTOR C A OC -9 F -‘21063‘t 4 a -6 -404,e ADDREss UC, PHONE TYPE OF 'Er= woRX, NEW INSTALLATION El REPAIRDIDDITIcoi IND SEPTIC SYSTEM PERMITTED IF PUBLIC SEWER IS AVAILABLE WITHIN 200 FEET OF Burt to INTITALLAnom VALI SERVE, RESIDENCE ilit COMMERCIAL 0 OTHER 0 MJEARER or LIVING UNITS: / Illfts1111 OF •EDROOMS: 3 MUMMER Of RaPtoy/Ts. C R OF SOIL TO A DEPTH OF 3 FEET, Eet /00-4,44- PIT/HUMP SOIL CHARACTER.41frksfy ijejo.4.4.- WATER TABLE DEPTH SEPTIC T SE TSAR NO. COMPARTMENTS 70 . A- 0 TYPE/MEG -FteArta — PI11.-- CApAcrry _0.1.1r/040 ."Ec / PRO TIMMY PLANT 0 DISTANCE TO NEAREST:ROPERTY LOX WELL _5-0 ' FOuNDADoN .'".: ' P OFT STATION 0 SIZE TYPE IF PUMP SAND OIL SEPARATOR (ENet oSED SySTEMI LEAciate 1.1110 '71.1 No, 5 LENGTH OF Lams t - tit,- .,...,,,4 I IL.rustANcE to NEAREST: wELL -.iv (.) ' FouNDATWet i 0 PROPERTY LINE__S— FILTER RED 0 mom LENGTH DEPTH DISTANCE TO NEAREST: WELL pRoPERTY EWEFOUNDATION MoUNow 0 WIDTH LENGTH DEPTH DISTANCE TO NEAREST: wEit FOUNDATION PROPERTY UNE lit.EPAOE PITSTS ‘Ig DEPTH 9' C ' SIZE .3(e ' NUMBER 011/TANGO To NEAREST: WELL 1 0 0 ' FOUNDATION /6 . PROPERTY LINE S- 1 BUMPS WIDTH LENGTH DEPTH DISTANCE To NEAREST: WELL FOUNDATION PROPERTY LINE DISPOSAL PONDS 0 WIEITH LENGTH DEPTH DISTANCE To NEAREST: WELL touNCATIoN PROPERTY LINE I HERESY CERTIFY THAT HAvE PREPARED THIS AFFIXATION AND TOOT THE WORK NALL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES AND STATE LAWS, AND RULES AND REGULATIONS OF THE SAN JOAQUIN COUNTY . NOME 01150 100 IJCENSED 'WENT'S SIGNATURE CERTIFIEs THE FOLLOVANO. •ICERTIFY THAT IN THE PETRO MARC E OF THE WOIK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN OUCH A MANNER As To pEcomE SUBJECT To WONSMANS COMPENSATION LAWS Of CAUFORN/A.I. CONTRACTOR'S HERM OR sue-cowrgActim sIGNATIATE CERTINEs THE FOLLOWING: II CERTIFY THAT IN THE PERFORMANCE OF THE woRK FOR 1111C14 THIS PERMIT IS ISSUED. @HMI EMPLOY PERSONS SUBJECT TO WoRKMAN'S COMPENSATION LAWS OF CALIFORNIA. TER APPUCANT MIX' CALL 24 Nouns of ADVANCE FOR ALL RICA/MED IN/IPECTIoms. compuTE Df‘AvoNG BELOW. ETARTNIENT uSE ONLY DATE: 7 .7 2--/ 2_ eTifa.".003ATE NAL iNSPEc TioN11Y7-elPik2 .2.-4415k1E tr-266 67/011 SUMP INSPECTIOit BY ACCOUNTING ONLY: AIDE FACE RE CODS LE MEG AmouNT sou11 to, cHECKaicASH loci:veto AN GATE sil /PERMIT NIRAIBER INVOICE • 'A a 0 ‘ \ , t — '7,..,-D 0 i 011.- ---7 i _, 6T:170g 1 is" a o a ....---b Pub. HOSIth SSP,. - Erpepo. 174 (3i95) NM CONTRACTOR ADDRESS LICI NioNE 0EATRuc noN LI Pax TE111141 I I HOW MANY ATB4144044, APPLICATION ACC ErGeo LIT /---e-e-1 ADDITIONAL CommENTs.