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11�o�U. of <br /> SAROAQUIN COUNTY PUBLTC HH"T VICES <br /> n'VXxUu, tTAL gFALTH BZVISIGN1�3a <br /> 445 N8,4 JOAQUIN, PUONE (209)468-3420 2 <br /> P O BOX 2009, STOCKTON, CA 95201 r t+, fq ?tlffn1 <br /> i1 <br /> 7w . <br /> ' �1lltF)1VtylFN1,3! ++i +t! rr <br /> Complete in Tx'lA1i4ate) <br /> 1AS41116&t1&ft to berobr vada to a" .Texgain County for a "rolt to conotruot ondJor SnstaLl the vork her+In desartbed 11'.s <br /> &V;ij\ie4t;taa to tmde in oamplxarrt• vtbh a" Jae4ufn County or4.im*io leo. 549 "A 186E o.nd the Rules o,nd ge}ltLar-tans at 8-n <br /> Jon-quiff gauu pubita Me 1 h 8 t'Ytt be. <br /> �rhy 4 4 t1Z1.1 O <br /> job Aodrtte .HLILMMIMIWt f sFN ftuD wo3r L P+mk:y CttY�tiXD�ry. Lot Size/Acraav <br /> 161100 so�rn�eayrt PA4Xw,4y <br /> owoof't Norma �( Gowl Addr6ts TPrW11,44 w14 91616 Ph"'6 b <br /> Of�Tqz-zla <br /> 4 <br /> t cmttot ! at <br /> YYPIE OP WELLIPUMP: NL tVIIELI, a MLL AE?LACEMW M DIFSTAUGY(r3u 0 Out or •rviOr uclz <br /> PUMP INISTAl.LA'noIV Q V$tEM REPAIR C) T 81t C3 fe0t1tt6rtr%s 1ta11 <br /> 01STANCE To NEARESX: BRFne T'ANX SGW01 LINES � OtSPOSAL PLO. PROP. LINE <br /> F0VN0At10N 1' A0ICVVVAf WELL OTHOA WEU, PITS/SUMPS <br /> IHTENOED use TVPE 0P WELL PAOALIM AREA CONMUCTION SPECIMCAT10149 <br /> ` <br /> C1 Induetrtal -- - - 0 CPO 9attam 13 Mantitea Ott, of We%Excavown Ota, of Weft Ctung s <br /> f i OameetlelPrtvtta Cf Gtovel ft:k 0 TOW Tvat of Cteh+q_ Speal(lceuotrt L O <br /> I'l Pubtle f Other tl nelta Otpih of Goo Sul TVpa bt Grout +erre- <br /> I I lrnpotren Ef Appfa,, btpth t 19Relom Suriso Seut Instalh,d by !<w <br /> It400 Wotk boM 0 Tyts1 o1 Pump - H P — — -- - l5ate Word Clan <br /> Watt 04sewetfoo © weft vlemster ... �,___.._ Saadi t Hat irtLL �` 3 -.h — JWWma <br /> O� o� <br /> 040th Filler "Aterxsx • x+wpsh <br /> Y E O I WO tC IN'* eepttp rYalem pe{mlHrd h pvtNla stlrw! rs <br /> Av4"blia wilhin 200 Ieet.I <br /> lnsteaaNOn will aAnro• iiettdehnt�... Ctxntnarclat�,_._ drhgr� .__,_ �( <br /> Hw"bol 61 SVW4 untie: � Number of badroomf <br /> :ra W 61 aoq to A eoOlh of 3 fbst: wot©r tablo depth-------- --- - � <br /> KrIC TANK © tie. Gon+dtnerwito <br /> a. TR15ATMe NT PLT 0 Method of 01imsel <br /> Distsm2i to nodrttr• Wtlt _ Fpundbl#pr5 Praptrly Lino <br /> I-EACHING LINA L1 No.$Length of Hoag •,�,. _ _ _ _ _ _ TOW lsngthliitt� <br /> FtVtA $ED CI 01tisnat IC nearest. Walt�,___,__, Foundation — PrOporty Lint <br /> Et:PAG£ MTS ( I papas Slit Numbet <br /> SUMPS (.t 01949hoe 10 11"rttt' WO _- P6undstton— property On* <br /> f$POSAL PONOS b <br /> Haby 0ROV that I Ravi prspamd this spoltation and that aha work wl#be done in sCeorpanrt with SRA.l6443utA County Orblrianotf state taws aPe <br /> W06 And 0#9VINVOM of Iha San 1oagwev Coutsty <br /> tetne towne►or ticenatd agent's t;grAi a eaeufl**the foilowinp. •i carlity that In the perfolmanae of the work tot which this permit Is tutwf I short no! <br /> F <br /> dyenv peraen 14 euah Alanrtdr as to#eaatnt tub*l 16 warkrt+Ws eomp nvotion taws of Cttldore0e."C6ntradim'i rotitep or rtr�contraotrn9 slgnat le <br /> iea the foowl,�t ''I terthev that in the performsAdt of the walk tot wtdch this pefrnkis issued, I theftemploy Aarsanr sttbItct to w it man'e CBntpansa <br /> ews at Cstffbrnla:• <br /> ha e000ftt Ati uta t a, Compibtt drAwino ort rt,verso iId <br /> nod x f� <br /> itis• „ bats <br /> , n f-PARTMENT USIr ONLY <br /> icitioti ACt <br /> 0a � <br /> fff <br /> tpttd by Grout inip"ood by _ _ .� Otte . fiinet lnspooton by .. . — Otte <br /> dittonel Con—eMd- <br /> +tp¢itcent 4 Roturn Kit copied tot Ssa 4o"01e County public hok ltb Sorviaee <br /> 8uvirannttt*i Hoftith potmtt/5orvicav CJ <br /> 440 N gad JdAgVin, P 0 Vox 2009, 6tkn. CA 05201CK 9 <br /> � f <br /> tNpO AMOU14Tbtlk xM T AM"60 ASH ttt:CEM0 aY OATS PERM" 140. <br /> .i <br />