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FOR OFFICE UH, I1PtP ICAT$Ot FOR SAWA
<br /> IGomptew in vololleaw
<br /> Y. �,. y ..., Tf3ir�rsyllt t »s t Ya+�ie+ern�ariefisiartl Issued 7: -,70-
<br /> Witaits is hereby timed* t*the Scm .l parr Loco' Sgwlth DiilYkct .#ar +� p � #� t +��cir and i��t}I 1�e � hereinA
<br /> destrit ett. This pppiica46aro Ili r edis In compis 41rth CiNattr W> Mane No. 549 and exiiting Rules &W Reguldfie"t.-
<br /> 1011 ADDR11SA10CA1tt6N1 ., .S,_. , ._.... . ., r lr �r.. .. .,._...._caft s 0ACT ,.
<br /> ftes 140me -
<br /> Address "{..._. ...... . .......... 1 __ Gtr ^ r �.�... ..
<br /> . ...
<br /> .
<br /> Cr�rorrac s Noi" - .` ,>,.. phon.
<br /> tnsiollavon will irrve� Residence ]-Apa+tmcns Hca*e 0 Co4nmmial aTrdilft Cel
<br /> M*fL%l [3.0th er .... ...............
<br /> Nur r of livid wrats�:,r.,l,w.,. Number of dfoor"s . .. ......Gar! I t,srtjsder Lvi vz* ,,... - ---
<br /> W40*t Suppltr: Ptiblic,Sy;stem ert+d ncn* 1_111.--- ., Pirivait+l
<br /> Chu7adef or wit to ae d"A of 3 leer: Send Silt Ej Clay Q Peat(D sandy town C.1 Cray Loam
<br /> lgardowt Ado iftot FotD tJt ria6•111_1.._. i#pets., ►yam:--
<br /> n, shawiing size of lit, lowtiOn of system in relaijon to walls, b4f4diogs. otic, Must lice pldcetl O reavrsd side.b
<br /> t1s tW INSTAUATHM-t IN* ,iiia t0nk Or Psge 0 p"iited If Pvbllc surer"*r*il*b3e w#th'n 20D fWj [
<br /> PACKAGE TREATMENT !e SEPTIC TANK �. aim Liquid 0*0 .a._ ..-.-.K,. .... `°i
<br /> Cupoeity ..ODD. - Type (& ... Moterkd,ice XIV �L. No, Gxnpotfrt engin
<br /> i}istars to mearew well
<br /> lt'.ACTlInEG LINE I t No. of 0"i
<br /> C th Of mach ilft— , I-i"'h .....,.
<br /> 1f 1161k11..._11 Tye Fiber .m6leri�al .,Dep lr
<br /> net -: �, , °`... � , .' ".}' . . ..
<br /> `Fou �}� tam
<br /> WPAC , MY ! E)tpsh Drtxooter NUM6V tack Filled Yes 0 No 0
<br /> Water Toble 00pth _......._....._..._... , , ,,,,itr k Sat to 1 111:.:.:_. ............._.__.
<br /> Distarfce to neoresY, Well i +�ndiation Imp. 'Liter ,_1_,1,,1,1 .....__...
<br /> itVAIXLAADWiil�!tPrev, Sa icaa + r lr g,... Latae _..,.. .,..............
<br /> S pfic Tante (Sx+mofy R iFWM,6nzs} _. ..
<br /> Di-sposal NeW IS I;fy RegUi=errtie4111
<br /> 1.0vow existing armd required addrKon an raevarso side),
<br /> 1 hen tt se fy 0at I hove prapoasrd Ikk 6100"'NM G"d sheat iho went will be In sucotxl"co with ion joequil"
<br /> County Ordimafton, Ste% Low*, and fitalet aiud x6gWastlotni of tke son io*gsrin Local i#OM airsWo.Memo wadw or Iger-
<br /> sed agewt►rbga+ts#rre cWttlf of tie f0*6win$t
<br /> t certify iltai is t%# ptrtera amw of drat work#we vA" pofflAt It tsewW, 'I slrarll ices*RM4eY MW per' in s a amer
<br /> ev to become rule to Weffkml t'sa`r Campemraiuiee Tows of Cal#anala."
<br /> S;gsvrrd
<br /> C� r
<br /> •".� f i
<br /> gy
<br /> �lfot
<br /> er than owner}
<br /> p6 A111'lYIt IT
<br /> A'"ItCATION ACCEPTED -BY
<br /> DATE
<br /> 8U1LbPW3, PERMIT lZll t3
<br /> ADDIVONAL COMMENTS
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<br /> ._. ., ._.. �� _.� 2�' ?� • ,n,.� -
<br /> &AN JOAQUIN LOCAL Hi:lk.£TH
<br /> 1.,!t, 9 1-'! Rev. SIVA
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