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EOR OFFICE <br /> _..... M. ArPuuTaN FOR sMrrATM PRVM <br /> fall <br /> ._...._ ..... _»....._».....__.._.. ._...._ lCaxlpbftft Tdltlkoft}• , <br /> . ....._...._.__ TMs P.-w*Expboe 1 Year IFrem Deft/seed Dose Itewd.'ir-ids-'!7 <br /> AppikoHon is Iwnby made to tM Son JoagtAn Locof tfeohh District for a xrmit to conshuct and instep OW week Iteleks <br /> described.This epplkatbn Is made in eompikmn with County Ord'inonce No. 549 and existfnq Rules MW Roquk*$CMI <br /> Joe ADDREssnouTIo� 3l,�O :G.. S.•.. ...Tra y l vd .awn TRACT <br /> Owner's Name _ <br /> Address ......... r L. X <br /> ............ <br /> . ... city ... <br /> .... <br /> ,._. mtControaor's Nome.... %Redinat HouseLCMn^kr:ial Orrod1�e.r'.Court <br /> Y ou.L�r.tfnsfotiotien wll <br /> Number of livkq units:.... �._.. Number of ...Garbe=o ie der ... ..__. Lot Site ..._ _.... ._ _--- <br /> hWafw Sup*j PuWk Sy-atem and name ..._...._.l-1. -.sr '�S� --L^- ----•........_.........._:..._.........IhiwN� <br /> § Charoctw of Boll M a depth of 3 feet Sand O Silt O Clay O PeatO Sally Loam Q CW-" Q 'y <br /> Hardpan O Adobe Rp A11 M sftrfal ...........1f yes,typ. rau_Q <br /> (Mot plat, showarq size of lof, location of spla in r*kMon to wells, bufklkgs, ale- mus►be pkted an twrw+e sfdwl <br /> ;#M RtfTALLATMi INo sW;c tons: or seepage ptt pwmftd if Isublk sewer is ovollaWe whhhs 200 fmtJ <br /> PACKAGE TREATMENT I ) SEPTIC TAW( Sin.._....__........»........................ OcIta Depth _.........__._...;._. <br /> Capacity ............ .....- Type ................... Mtslwfol. ................. W. Caltperlttftnb ._.-.•.....O <br /> Distance to nearatr Well ......._......._._. _ _... ./... ..__.Prep.Lhrl 2..•r _ 0 <br /> UEA04M UNE ( ] No, of Lutes �.._....._. Lecglls of eojf lne�.__.... Twal L� / -_ ••- -_.`P <br /> / ( yy <br /> 'D' box ...._! -. Type Filter Mater�iatl �.... .,..-._..-Depth Filltter Mghri � . dCrC.. .: ..�..... <br /> Oislance,aro,n.or��sr Well .. Y.. cion ..... _............ Lk" ....!-k--- <br /> SEEPAGE MT I I GePIIt •.T�•••-• .. .—... Nwnber ..._....3 ..... fRted Ya; 4N N . <br /> Water Toble Depth to m -_ _._...._._. .-----.-Rode Site. .,. <br /> Distonce merest:Well _ ..._. <br /> ... _ .. Fouttdolien _._•--- . Prep• U".......�_.� <br /> _.._._ <br /> RBAIVADD "M IPmv. Smitalon Pumit G� LL Ll dl(-',l L-. DaN __..r_ 1 <br /> Sepfk Tonk (Spedfy Requirernentsl ----------- <br /> --...— :a •___... :. _.. ---- <br /> DiWosof Field fy P.aqu . .../-�� �1.1�.C:--._, `•••..`.'.( S .:1_s^•� �eG GC _...... <br /> .. . <br /> ._ <br /> (Draw a:Fstkq a+d requked addition on tetwsa$ide) <br /> 1 Yereiy osrtily tbet I hetn peeperesl ibis oppocodm ssd Ikaf Mte wreck w o bo done M ssawdema wdlls Ifew.Jsmpb <br /> coval r Ordle "am Heft laws, and Ralee and Regule"m of 60 fess Joeraim Leeet ifeoitfs ObukL Nsmt awssw er now <br /> sed wpewlr siptatttre serNises the hllew6tg: <br /> "l r«tMy titer fw the peAwwsewce of dw wwk ler wrMsb lhte pwwtif Is owed.1 sboM wM eaapley ewy persm b ends eeeewer, <br /> a to svb(ect ft Werbaea's Cor ise"GO ew laws of CelUwsks." <br /> pf o&h Ikon owner) ("�� �• <br /> _f OR D ARTMHiEvS1 ONLY <br /> APPLICATION ACCEPTED BY d-L.--� .... DAT 4/ 7*7... <br /> 'v'C./.�d- . ..... <br /> eUtLDING FfRY0 ISSUED � .. ._.._.._..._..... .. . ..... ...... DATE _........... ..................._. <br /> ADDFTIONAL COMMENTS . . ._.. ._ ._.........._- . ....... ................................. <br /> Final Inspccnan by: . ' G� ��W... .. .._ _......_.. _ <br /> FSI 13 2L 1-64 ��" ;,AN .JOAOLRIJ LOCAL HEALTH DISTRICT 8/7h 3M <br /> I <br />