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M a r1 Jrti <br /> APPLICATION FOIL PM]t a <br /> SAN JOWIN LOCAL OWN DISTRICT <br />,� 1501 E. iiA1Fl?OMI AYE.. 510GiCTON, LA PERliIT ND, ..�[�YQ � �� �:� � <br /> Telephone (i09) 4fi&091 <br /> DATE 15 SU!_'97,��;J�{ t <br /> PMT EXPIRES,1_YEAR-i'i"TATE ISSUED <br /> (Complete in Triplicate) <br /> Applichtion is bereby=WW to tht Stn Joaquin Local Wealth District for a permit to construct and/or install :he were herein <br /> descHrad. This application is amde to Compliance with San Joacpin County Drdinance Ito. $49 for sewage or Nei. 1862 for weIZIPunp <br /> f mad the ltwles AJO l tions of San in Caul ith oistrlm <br /> Job AdarFss Subdivision %W ,`. i <br /> Owner Is W&W rens PuuarFe -- ' <br /> Oontrattar's ifa�e Ltcease No, rho" < <br /> TY _O'r HELL/PUMP VORK: NEM MELt Q 414 RMAC£NFA Q DESTMX'TIDN Q <br /> Pimp INSTALLATION [j SYSTEM RFPAIR Q OTHER 0 <br /> 1 >� 01SfiANCf,fO�1I4RESTs SEPTIC TATIK SEVER lines_ O'.`.DOSAL fLD. PROF. LINE <br /> f"DATION AGRICULiLM DELL 3T14ER YCLL_PSTSJS6VS <br /> NTENOED USE E71 j FfWLIX ARD CMtRUCTIrJ[4 SPECIf1CATIOM d <br /> C]IMdrrstrial 0 Open 0ottoM Q rant'-ca Dis. of Well Excavation -_ g <br /> t :[j 0eimestitJ�rlva to .. ..M ©&screS^Fate u -0 Tracy Dia. eve!1 rasing <br /> �]Aublic C Other dOalta Type of taster) <br /> r) :. Q Irrigation ��.-.�x. 0 EAitrm ipcctfiraibans — � .� � 7 5 ,5 <br /> (]Cathpdit ProtbCtion Depth of Grout Seal <br /> Q!>+ophysiul Tye of Grout 4i F <br /> QQifitrr Surface Saul Installed by <br /> iiepasr wrk Dona Type of hop ;_.._,_..� limp. �» r.SLate lurk Ibne -- . <br /> W11 GmtkKtiom Ball D1aaFet6i• Seal iny Miaterial (top 501) <br /> Depth Filer.Wteriat (Aelow 501) •-- r - ^"--_ '! <br /> TYPE DP SEPTIC VOW in IiiSTALL+TION itEPAIi MITIONX (No septic tarn ar seepa':pit permitted if,public sewer is �v•,: � <br /> i s &wadable within 290 feet.) <br /> liistallatioa*I%I 'serve: osldowdl Commercial Z Dari' <br /> Ihwber of living units: _IIWraomr_ Nudw'o# Lot size y r-NC�Y <br /> Charsct*r of soil to a depth of 3 foot:L i Maur table depth R <br /> S' <br /> SEPTIC TANK Q Typo/Mfg _ !.':«:i:y No. Comyartaents <br /> PiIB. TRUTNENT PLT. © TYPOMN kCapacity Hetbad of Disposal <br /> —T <br /> SISTEM Q Distanca to neest: Mall N� FOundation <br /> r�tPrv�rrtY Lite <br /> SENA6C <br /> DES VUCTIGN <br /> INfr LINE 0 No. i tA*gth of lines Total iengwsize ' - <br /> JXACK <br /> b Y <br /> ILTFlt Ern Oistantx to RDamt: bell F01mA&tjon Property'Lift <br /> SWAGE PITS © �► Size Number k� L <br /> �a <br /> S0iPS IQ Distane!'to'nearest: Moil" ' Fouwdation Property Lire d i <br /> s OISP05Al PONDS <br /> I haeabY certify"that I twtveIn*pirap this application and that the work will be done in accordance with S: qu tamLY <br /> onliriaetW, stat* laws. aro rules and regulations of Cha Sas? Juagaih Lou/ Health District. <br /> iim ewer or.Iicenxt4 agrnt'f stbutum certifies the following: 'i Certify that in the perfareante of the work for uhtth this <br /> pexw'It is iSPAd. I gull not away alar person in such muwer a: to bacore nMect'to wortmanl comaarusation lass,of Californic.` <br /> 's Miri 'or�CantVactiog signature Certifies the following: "I certif.-tMt In see performance of the work tCr which r a <br /> 'N' $ PIK . is i i sha31 :ay rsans s'Aject to.rorlinn•s toWperlation law!of Californll. 7 <br /> i s tions. [neglect:d <br /> COS! Title: r,& <br /> btu• <br /> i'a ti <br /> i t I <br /> y Application ACCCR sd by R ! I PAAiltEhT USE ONLY Arai if Stk 46"7EI rid; <br /> r AdditiaWal C/1u�Mlti: Q Lodi :49-362I <br /> ►it or trout InspeCtioa Qu Q Manteca 823-7104 <br /> A' FinaF Impaction by ., Datc�� Q Taney 835-6385 <br /> r� F <br /> . AG;1#carat - tbettwn all t:opies W. Lmwirorrm,antal Haalttu PersitJscr+llcts 1601 E. Welton Ave.. P.0, Bose M. Sts., CA 45201 <br /> 4 .y <br /> fEE AM ANOgiiT DUE AMAIT'il ITTED RECEIVED BY DATE PER41T ND. } ' <br /> INFO { { t-+I,S• t Q $3 --31 L{Q <br />: Cil 13-24 MV. I0182 {y k I0J82 Wo <br /> �yry� r <br />.p �M1, ��-'^�'��� u.s •rte^' ,... 't^' a�i .w r.w 'R - � y� „�•� 3 <br /> pry' 3 iW " <br /> "phrJ <br /> , J <br />