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SAN JOAQUIN COUNTY PUBLIC <br /> .VICES <br /> NVIRONMENTALHEALTH DIVISION <br /> P.O.BOX 388,804 EAST WEBER-AVENUE,STOCKfON,CA 95201388 <br /> (2991469-3420 <br /> NON-REFUNDABLE PERMIT EXPIRES I YEAR FROM DATE ISSUED <br /> Ic.nryl.b IR trbnea.) <br /> AFRICATION 13"ENTRY MAGE TO txE BAN JOAOWN COUNTY FOR A KRHIT TO CON[TA T AM].OR INBTALL TUE WOW,OESCNBEO.T a MANUTATICH IB WOE IN COM0.IANCE LATH LAN <br /> AAOVIN COUNTY Df VELOPMEMT// H/A✓fFP(O`-1�1J10/.1 pND L11E 6T AlA /jFBANJOAOVIN COUNTY PUBLIC MEAItN eERNL[e.ILNVMONMEMAL MALIM OM610N. �,1,� <br /> AB ACCUSE....ARISE ` A, 7✓. /�O CT' E- T Lot et �-Ie f/ <br /> OWNER.NAME�oA�J Yff Q� ADCLAtl BIOME <br /> Sea, .ONURACTo <br /> 2I ADDNERE 37i= _D/ )e�_rLIL!'oi�aas' »IpHEro9GG -�aLl <br /> DREM. <br /> 111.Of IRITIC WOBR: xEw lx.rnrutlOx REUABORE RTRe Cl DIATBVCTION❑ <br /> IND SEPTIC INSTEM PERMITTED IF NBLIC SEWER 1S AVAILABLE WANIN 200 FEET or TUR Own I NRC TELTNI I I BMW MART <br /> // Avgle.tlm I <br /> INBTALAgWILL VE`. <br /> LLM IfAPEAOENO <br /> L[IO fC.AAHERCIA1❑ OTHIA Q - <br /> NUMBWOFVAAOVHIT.: / NOV..Jr. 0.S-��ryVNE, aF FM XOYEEt:__ �+ <br /> CHARACTER OF 6011 TO ppEITN OF%f[fT: $✓IT UIT/.IISM EOII f.NABACIfR: WAIfP TABLE VFUNI Of <br /> BFIi1C TAXp/'AGBF tRM GYTYPEMFO �CAPACItt /1r?(i NO,COMPMRTMFHIB_ r <br /> ` FSO TREAT M1 RpN10 DISTANCE TO M ANUT: WML F.ON.Ar10N PRCRRTY LINE <br /> LFT.,..a.❑ SIZE TYPE Of NIA, EANB CII.FE'.OF IFNCLDEEC SYSTEMS <br /> Lu4[..ON B'NO..LENOTT.FUN[9 4 — -//J'' "MINCE TO NFMHENT:PML/;n I....AT.H_/Z mo,RArvuRE 1+�� <br /> FILTM.Ee ❑Yry.F,l CNARTN OE,FN�DgiAMFr TO NFAM6i:WELL_FOUNDATION FUUBENTYLRS <br /> NN U DEO ❑yVMF. I£NOTX DEPNI DISTANIFF TO NEAREST:WELL) FOVNDATpN MORRTY LINE <br /> fkVAOE NI. 1J DEpTN Z5- MIE 7GHVAI.FN�j_DRIANCE TO NEARFST:WELL/J/ FOUNDATION_ RMBERTY NNf� <br /> .UAP. ❑WgTX LENDTH EBIFTH OUTANCF TO KARAT:VaLL FOUNDATMIN PROPERTY LINE <br /> OUR O.AL Be... ❑LAOTN UN.TN BEHU. UATp.E 10 MARE.T:WELL FOUNDATI.Ni NbRRrV LINE <br /> r I HERESY COURT THAT IHAVE PIIEMPEO THIS pPRCATRH ANO THAT iMAVIR WIIL BE MINr IH ICCORO/Wf.[WITH SAM AAOINry[OVHry OMIN.VKEB A" STATE TAWS,ANO BVL[. <br /> ANOMBUTAFWM.Of 1M SAN JOACMN CO VNTY.NOME OWNERORLCENB[D AOEM'B 61ONATVRE Cf RTRIEB THE FOLLOWIN0:9CARTARYTHAT IN THE RRDRAAND OFTNEKOFk FOR W"ICN <br /> THIS UERMR IS BUFFER.I WALL HOT EMROY ANY PERSON M SUCH A MANNER AS TO YCOMESUBJECT TO AOIRMATIR COMNNRATION IAWB OF CANFORl1A: CONTRACTOR.HIWNO OR <br /> .VB CCNTWCTUM SIGNAtVRE CERMIF.THE FOLLOWING:'I CERTIFY THAT IN THE F[ROMAMM OF THE MUST FOR WHCH THIS BRUNT IS ISSUf0,I SHALL BURLEY NRWNS SUBJECT TO <br /> ...AN'$COMPS WS OF CCAU/UIIENTRAATTHHEEA{.JI,.MEANT MUST CALL 2E NORM IN AOVANCE ON ALL MOMREO W6NCTIONR, COMRIT E ANAAFO BELOW. <br /> EIDHEO% Lot (�L(FJ TITLE C/W DATE:// a/ ( Q <br /> ROT RAM IOMW lO 6CALE1 SfnLE <br /> NAMES1. <br /> OF CL E TR OR REARS NEAREST TO OF ROFHOMO FIM FRORNrY. A N <br /> LOCATE N OF HOUSE GBAFTE OISEAL SYSTEM OR PMNSED <br /> 2. TLIN <br /> VE OF MMFFR <br /> E PTY,WRH DIMENSIONS AMC NORTH DMR1 <br /> ipN. E%PANWN OF SRWAOE DISPOSAL SYSTEMS. <br /> S.OIIAENSIONEO OUTLINES AND LOCATION OF ALL EXISTING ANO PROPOSED STUCTVPES, S.LOCATION Of..WITHIN RAUCS OF ONE HVNONT,lfi ON <br /> ` IWI,UMHBCOVERED ARAB SUCH AS PATMS,DNVEWAYS.APER VYWIL THE PROPERTY OR AOJOIHIHO PROPERTY, <br /> i <br /> SeeASSAY <br /> _ 1 <br /> u a <br /> p <br /> v <br /> RA;— C _> 3i t E/0 <br /> G -1" 6�,fF �3� <br /> See <br /> vd' ��52 - Nome . <br /> FL <br /> NOv A 1998 <br /> See <br /> f <br /> i <br /> F ROEPMTMENT V6E ONLY <br /> MrfuulloH.cc[n[D BY Lti u <br /> 9 <br /> DATE: p_ <br /> Sea 1M,.BIT NNMPINNECT.11 By BNALI aRCTION IF <br /> E 1/(/ <br /> AOOITIOHAL Co.IIT E: / <br /> ACCOUPNO oNLT: A FAC[ <br /> r <br /> vF CODE FEE IRO AMOVM1 RPAlIT.ppall PELOVEO BY DATE SP/ppMBMVO <br /> 1i NVMNI IICEi <br /> Ji <br /> 'V <br /> PUD.Health Serv.-EDYIIL.174(X96) <br /> bee <br />