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_ APPLICATION <br /> FOR PERMIT <br /> L fiAli JOA++lUIN TTY PUBLIC ZBALT8 SERVICES <br /> ON <br /> ENVIRC�w�TAL ggA+T1 C,& 9 2 <br /> P o 20093, 6� �? �� $5201 <br /> - - (249) �G�IP►9 �� <br /> (re" lets iD Triplicat®) ' <br /> 'thea <br /> rein dseeribt6. <br /> uin Cotmtr <br /> for a nrrtait so eazstlue <br /> Lica. of Bao <br /> �r,ta z- Joao uin COtaLy ordSma I LTA' <br /> �ryuption Ls harrb7 y aaea Y1th baa Joeq A� <br /> coutrr.tom to coo 10 od3� 'Cr_ ' Lot 8ltta/Aea`aaie <br /> dort4v"coot?1labllo Yea]tIa 8.yrrlces. City <br /> 0 h1y itA p CewlwA I(arM®st pRb P $'fix- 9506 <br /> Job AdONO xw{iCA -10� <br /> Addl... "K y� t Phone ��5j�+1�-�3 � <br /> �7levtorl US 11� Suit" D <br /> Owner'• DIIO P+Kt �LqE S t¢ 3 <br /> t 7 Uctnse Out of 1orvics Well <br /> o DEgTRUCTIDN O ri Vall <br /> �ltOYttdYl;r! ¢c 11111111 <br /> e t hd7+etL p CEMENT 0 OTHER !0 IloniLo ttt <br /> Coneraeta _.--.--• WELL RE LA <br /> NEW WELL'Q SYSTEM REPAIR q yut� PROP.LINE �Q- <br /> YPE Df WELLIPUMP. O' Dl ipo SAL fLO.� <br /> PUMP INSTALLATION 0 f SEWER L1NE5 -�^ '� fL plTSlSUMPS � <br /> o ' OTHER WELL <br /> o15TANCE Td NEAREST:_SEPTIC TANK .L.O fir-- AGRICULTURE WELL 2--�- r <br /> FOUNDATION - D�.Of WON Casino <br /> PApELEM AREA CONSTi14.ICTll3N SPECIFICATION .r u <br /> TYPE 01 <br /> �---- Dia afvreaEYctretionpttitiCattt`73 Gant <br /> INTENDED USE <br /> �i^:nd.u�atrrel � L3 imICo Y�DI Cna- <br /> rr <br /> Q0 <br /> t <br /> Ysof Grout,sort T <br /> ]GrovePack O Tracy of Grout a �r <br /> XDmsetictheir 0Oa`4 S' a 5arl installed DY . <br /> CP%l � Appros.Depth 0 ENte'n State Work Ron <br /> CJ irtrpetion TYDs Of Pu+r K oat M.P. Lerial A t?aDth <br /> llrpah Work Do13 8�,alit��• Lh <br /> Ir <br /> tNsn DArtteur �r� 9111er arterial t6 naS rrrutted'f pubt c.rwar is <br /> WON Destr4ctlan 0 - No sap c typrm Do <br /> Depth raESTRt3CTION G wa+tabte within TUO 1Nt.l <br /> NEW INSTALLATION A AEPAIR,AODITION t"I <br /> TYPE OF SEPTIC WORK: Other�� <br /> _ commercial pt Rea'd•nce r table 61P <br /> M• Wato <br /> teYtgn vwia N .�-_„� <br /> ' !r►s f bedroom <br /> r <br /> T its.� Numbs o .ComRan rn+nte <br /> f . <br /> un No <br /> Numo•r <br /> o kring <br /> ' ICTaravol of soh 10 a depth of 9 f.et: Capaeter-�� Mothod of 000641 <br /> C) Type/Mfg <br /> SEPTIC TANK P,"rtY Lind <br /> pKG,TREATMENT PLT.0 Wen <br /> Drtt .�1 Foundation�~ <br /> ' arta <br /> to merest: <br /> ,.� Tord Nnpthltile <br /> No.i Length al lines Property Line�--1 <br /> I 'e <br /> LEACHING LINE 0 Won�� Foundstian.ter <br /> FILTER SED Ll Distant IO rwar�=: <br /> .y .umbar <br /> i t SEEPAGE PITS I I 0I- '�-��_Wall�1- Foundation�— <br /> Property LInS -�-� <br /> LI Dister4o to noarost: <br /> SUMPS nu with San Joaquin county and nervi era tote Iewt.and <br /> .-+ 0 h thio permit Is i,auad.I attall rg7t <br /> QISPOSAL PONDS epa`d this tpplication and that IFN work Will be do in eCGafda , naturt <br /> I hertbY Cenity that I Pave pt I grtilY that in iFN t�Ap1msnct o1 the vwyrk for r.1tiC W tu�LonmgnC s m <br /> following; rwns eubioct to work^tan'e CDmPanse <br /> 1 I ruMt <br /> and rill,0, ions of then•.siprNfuneCconifties the aft to workmen"'comptntatian law.of Citiiarhau Cpl a P616 t hiring <br /> Home pyyq+rr Ar IicanNd a9 nnar a to become 11I rmit is itsued,t sralt smPtoY OO <br /> i-� Home any Parson in such me ormanc0 of the work <br /> for vfiich thio pa <br /> cenifias the fottowin :'Y prtity that in the pert 10 I} 9 <br /> inspec11O°a.Cools.dravring On rsva' side. <br /> 1bn larva Of CMi1 14��t d� at.: <br /> The appiieartl at for Title:r P!a !t fi <br /> [ti T USE' /) 7 A�a '7 r <br /> Signed F (/ e. <br /> pn� Date <br /> I ' <br /> Lion AWPtsa by Fillet Inap•ctbn by <br /> tg ApP>jCe Data�t� <br /> f . Pit a Of0Y1 WAP.-con by <br /> Cortnrau: TH eg}IYICYH <br /> PU BAN OI&QUIN CW <br /> IVI 1100 IT/HPRYSCCA 95201 <br /> ✓Apglieaat-1teLvta <br /> 611 copies to% �IYEJAOggcNT#L BBAt.TK DIYff3Tbtl PPAa TD.t, <br /> 4EN, A.p HOX SDDOO ►ERM11'NO• <br /> 445 It SAN T'7AQ DATE <br /> 4 [�K RECErYED <br /> AMOUNT REsiTED CASH <br /> , Ol7 <br /> F5d! FEE AMOUNT DUE <br /> INFO <br />