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V SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES y ENVIRONMENTAL HEALTH DIVISION �+/ /8 ps�j� , JL/6911801Y P.O. BOX 388 304 EAST WEBER AVENUE, STOCKTON, CA 95 I-M RUM 4883420 NONREFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED ICamplatA In Triplicate) ATION I8 HEREBY MME TO THE SM JOAOUIN COUNTY FORA PERMIT TO CONSTRUCT ANDIOR INSTALL TIM WORK DESCRIBED. THIS APPLICATION IS MME IN COMPLIANCE WITH SAN JOAWIN COUNTY DEVELOPMENT TITLE,CHAPTER 5-11�1I0.3 AND THE STANDARDS OF BAN JOAWIN COUNTY PUBLIC CHEALTH�VICES.ENVIRON ENTAL HEALTH DIVISION. 8 ADOMSBbR APINP I` I [� (��ee144((�L--l/--�tJJ.• f1YY��,JJLLnnJJ ! LOT SIZE- 14NAME 14� ,al RE-J PHONE 93/—o 967 COMMCTOR { I E ADORE6Sy000� /V• L/.`�1�,, An IY� L10EfODS/1 PHONE -7 �UB CONTRMTOfl ',-moil ADDRESS N. /Z ` rvl�PHONE TYPE OF SEPTIC WORK: NEW INATALLATIGNI REPAIMAbU TION 11DESTRUCTION 11 IND SEPTIC SYSTEM PERMITTED IF PUBLIC SEWER IS AVAILABLE WITHIN 200 FEET OF BUILDING.) MMC TEATI.I 1 1 HOW MANY I1PNIa•tlon E INSTALLATION WILL SERVE: IIESIDENC COMMERCIAL❑ OTHER ❑ NUMBER OF LMNO VNITS:�_N 861 OF BEDROOMS: N1M1661 OF BAMOYEF6: �f^ HARACTER OF 6011.TO A DEPTH OF y3, SG FEET: //-'F LJGE.'£PIT/ R CHARACTER: !iAM1F -L SA NM'ATER TABLE DEMH �EPTIC TAAWOREASE TOM ITITYPEIAFG I CAPACITY/'�� E=,LJ/. ND.COMPAFffMENTB - Cz PKO TREATMENT RANT 13 DISTANCE TO NEAREST: WELL—Z 5=� FOUNDATIONS n , PROPERTY UNE _ 11 LRT STATION❑ SIZE TYPE OFF PUMP •�/q SAND OIL SEPARATOR(ENCLOSED SYSTEMI CNNG UNE � NO.A LENGTH OF HNEB( J 7]C/ pIBTANGE TO NEAREST:WELL /2S VNDATION PIWMRTV UNE J` r� LJ 1 LTQ BEI ❑MD111 LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION POPEHTY LINE MOUNDED N❑NSMDT" LENGTH DEPTH DISTANCE TO NEAREST:WELL rFOUNDATION TPGOPERTY)INE �EEPAOE RTS ENL DEPTH �1 �J SUE �Ofl NUMBER Z DISTANCETONEAMW:WELL Z2S�I-FOUNDATIONly 2--EP...MM •+ UMPS ❑MDTN LENGTH DEPTH DISTANCE TO NEAREST:WELLFOUNDATION PROPERTY UNE DISPOSAL PONDS ❑WIDTH LEHOTH DEPrH DISTANCE TO NEAREST:WELL FOUNDATION PROmBTY UNE HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THAT THE WOR(WILL BE DONE N ACCORDANCE WITH SAN JOAGUIN COUNTY OHDINANCEB AND STATE LAWS,AND RULE; REGULATIONS OF THE BAN JOAOUINCOUNTY.HOME OWNER ORUCENSED MENT'S SIGNATURE CERTIFIESTHE MMOWNO:'ICCIMPYTHAT INTHEMRFORMAN(M OFMEWORLFORNMICH earmts mma IS ISSUED,I SHALL NOT EMPLOY ANY PERSON N SUCH A MANNER AS TO BECOME SUBJECT TO WOMMAN'S COMPENSATION LAWS OF CALIFORNIA.- CONTRACTOR'S HIRING OR BUB-CONTRACTING SIGNATURE CERTIFIES THE FOLLO :'1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I AHALL EMPLOY PERSONS SVWECT TO WORLMAN'8 COMPENSATION LAWS OF CAIIrORtIA THE PUCANT MU$T C LL 24 NOUM IN ADVANCE FOR ALL LREQUIRED INSPECTIONS. COMPLETE DGAWING BELOW, LIGNED K TITLE: \ � • DATE - L MOT PLAN IORAW TO SCALE)SCALE.-IP 1. NAMES OF STREETS OR ROADS NEAREST TO OR BOUNCING THE PROPERTY. 4. LOCATION OF HOUSE SEWAGE DISPOSAL SYSTEM OR PROPOSED . OUTLINE OF THE PROPERTY.WITH DIMENSIONS AND NORTH DIRECTION. EXPANSION OF SEWAGE DISPOSAL SYSTEMS. DIMENSIONED O VTUNES AND LOCATION OF ALL E)USTINO AND PROPOSED STRUCTURES, 6. LOCATION OF WELLS WITHIN RADIUS OF ONE HUNDRED FIFTY IT.ON INCLUDING COVERED AREAS SUCH AS PATIOS,DRIVEWAYS.AND WAIKB. THE PROPERrY OR ADJOINING PROPERTY. o` ioJ 0. .... .. `L eh a aR 14 1�1 :11 Ia«� ._ . .. ....... '.......i .. ..P .�. ...o.... f .... ..:..... .......< :. y t ...: ..S ...:. .. .h...... :.. c ... ......n ..... <..........P . ..�...... •. .. ... ��YYY..... 1 PAYlIA�N7 � ITEC LVD .._ ..... .. . < . .... . RUf 2 0199 _. .... .. pOOLIC HEiALTHSpRVICES - .� b+�( AAA. .... ENVIP©. . . .A.... HDIVISION.._. '';