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<br /> OFFICE LtSE� ' 5ti :?t ° F"V '
<br /> � . s APPLICATION FOR.SANRATION P>:RMR " ; y�- nIC
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<br /> F w � .:it, Panni►HIo... r.......TC .�
<br /> _ (Camp"ie Tdpllcate) r �'� K ��• u ",
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<br /> ..rar r€ .1•� S�..O ..i
<br /> • �, K} rThb Ihnait Y ! Ysar frrewt fiaie bawd ' ,• Oats
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<br /> Fs �y=�';'Tf':t `•f. �t k�"`.t...� '--, �E- r .rc- ti 7* =P!, ,• - _, .-.• ii.
<br /> 4 i Applloallon is:lisrstby made to tM Sdh Joaquin Eooal'Heaftf� Di�trtR for o pKmit'to oonetruef:ond:fntMl) thi,w�eeli�liRnin
<br /> detEribed This applkation is mads in compliance with`County Ordinoncs No.-Sr19 and existing- and RegulaHetar :..
<br /> $ got; n►oartEssnocATora p t 3 !.�$ 1�o ks frt_Snl� ►Q cErls :::}
<br /> kI Owna: Name "r !'14 n k' # ; R t' r ti '
<br /> l .... City
<br /> Contractor s Name
<br /> �1.�O to _ i19lKja -C Llosnse5.'7;f Sr} ftltoney��..' �,
<br /> t .• • '- _ - y -: 4 tg•r, h k. f F„„
<br /> installotian will terve• :Residence Apartment Floui+l]Conintercicl QTraller,Coui
<br /> ' yy et. g}r- r > ak o-� r•:L--t y r r r,ti.- ! ,i 6 ,l•r.-t r ;y_-.
<br /> Motel Q Other ...........................
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<br /> oflivir►g units Number of bedrooms . Garbage Grinder N fQ "Lot Size
<br /> _.:u 9 i r � •'' r `�`i" � �` -•fie - t-r-,r.t,,ri ref'4 -ti .r
<br /> Water Supply! f�rblic S►sfem and name :.: frrivaM'�;
<br /> `."s•ti
<br /> dlOre[ter of bit t0 a depth erF 3 beets Sand _ 5ilf❑1�'day Q Peat Q .Sandy Loam❑ pay team ,
<br /> Adobe Q., Fill Materialyrst�lype�........................
<br /> _: ±S•, 1.'w'ar.---�xf -. :^a•a _s�,;• t,.- >>aer: - -- - :ra. _ i.., j .r,:.�:•ter.s._ vs_...eF.•€•. srk- -
<br /> 1 �✓ F �%
<br /> {iPlot plop, shawitp aze rot lot,`l000tion of system 1n nlallon to wells, buildings, etc. must be pliiad eny,rwqrte'sldel;
<br /># - �,.rr >t>�r%•.��`_f__�h r�^�•�,.Yria.ct
<br /> NEW fitdfTAlLATIDNr !No septic tank or seapdge pit permitted ff public sewer iR available wMhM�t)0 feet, .°
<br /> > a q r ,x lu 1�rx�,
<br />� � ,>�PACKA�E�TfiEATMENT j]',,YSEPTIC TANK{}tixx�,�' -Sire.�x.10 Q 7� � r r �- liqukl Depth � ��,�` .
<br /> sfut"� r "Fy r y - e } tr: -rzt ,•tt ? {i•7' ,-•
<br /> =' Capecity! s • �ryp.Q t ri�C Materia)CantP ef,`: No Comparhnants =' ..
<br /> S n'�f'`zr�.3vi r'�Y.D .r-. • r a.s r.r,,,'G s 4 '^61st-`p"S..
<br /> F , 1;,,�nt-;
<br /> nearest, Well �, 'FTFoundatlon � r,Prcio liiNilXY.,IINEj No of Liras .` Length of earn ilnb SIO '. Notal L*ngtit� Dr:: :: �`�
<br /> °- rv, `iG'N -r,ki• dih'r .+ R}. e x ;, , y -...� .;kY.i a:..t '��4'•pp, ' �A
<br /> .�r RQ� Zan - ts�'ffi.+4'�. .:P/
<br /> Box 1 � Type Filter Material"� 2 .Depth later_AAatarlgl _ w .T!
<br /> It '�s ,i° �; DistanesYta neareste Weli I: Foundation',::r�,lJ §i'r'olierty i.Mi �.
<br /> !6
<br /> 1 j'� fir' Aepth�`r� l� DierneteriiP7'A Number)
<br /> 1 r„ f _5 "'� g'd}•�6Fr „'6 4-rr n ��, r
<br /> • � y'S� -.�fi Water Table Depth ° ; i f .
<br /> 9 ra tfxEi}f�riq s �" 4tZ
<br /> I V �J; j41 S f t1
<br /> , Distance to nearash WeU Iyr Founefntionb?• Prop Line��JC•IC� �.
<br /> ■���r�/�T�.yi lis r.1�-'cFa�fi•
<br /> -' h R�A�AD�! Sanitation Permit t ; Date
<br /> kv - r. r� i s?; rr•�+,' r rx r n -jx. �, 6 Frs y •r
<br /> `Septic Tenk�l ifY Raquiremetsh� . : ..............................Y
<br /> 4 �- rS'" rei{ro
<br /> °' Dispose! Field (Specify Re�virements) .................................................a r . ,tel
<br /> i r i,}7•i4 ,c-�;.�p 'e"'if -.y 7"r ;. ,. i r }''r� r ' , - r
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<br /> �j r rIa 0.7e• f - -aY -.1 `u yw ad k fi 7 7 } v s cr '^e F� sr kiif�'r "F}' t 4'.til'-FSir4t1� �I
<br /> -�''h (Dreier existing and requirod.oddilion:on rs�wrte tidsl-� 'wr r'w7#' i•`'«s'''4,,. .� a
<br /> + �``� w ! enby'taMify tl+es!:1111144 propared this appBeation and that, tke Werk•wili.be roue in a ewdw�e wN6 Sat$JeMttM'
<br /> :r Gamy mdlnances, 3>a»Laws,end Rules and Rstqulotiens ai thr hew leaquin Deed Iledth Qitlrief`Nesasi rwwer K fipeFr
<br /> sed agents signatan certifies",fill
<br /> ,•1`cirtiltr;thot in.the pirlonnan"e!the work ter which this Penitis issued, I GIMA wet empl"0"_.'ersew in saeh wa
<br /> ai,Nbeeowse sub man's-CO pensafion lows of Cpliiernla" f y Fw ;iyY^ SG pk s
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<br /> .SlgrleCl t i Owner x a �'
<br /> By ...............................................r ........................ ...... Title . . . -... r
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<br /> u lif other than owned t S'
<br /> .FOR ART EPR USE ONLY
<br /> APPLICATION ACCEPTED BY .c� ?�l� GATE
<br /> i
<br /> BUILDING` lSSiiED
<br /> r , DATE ,{•
<br /> ADDITEOriAL COMMENTS.:.. ................................. :.... .:..-....:..:.....:-...... :....
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<br /> �...... .......;.... •
<br /> ,. Final Inspection by ............ ::..{/. !� .... oto l.F jam/. �4
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<br /> D
<br /> EH 13 2h 1-bA Rev. SA JOAQUttJ LOCAL HEALTH DISTRICT + '
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