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APR-05-1996 11:03 GEOMATRIX FRESNO 209 264 7431 P.02/04 <br /> APPLICATION 0 <br /> SAS! JOAQUIN COU2 tri ppBLIC BBiLTH MMVICSS <br /> jwITAL HSALTS DIVISION <br /> 445 N SM JOAWIN, VIRM (209)4"-3420 <br /> P 0 BDS 2009, STO('.KTCn, CA 96207. <br /> (Complete is Triplicate) <br /> Ap�L1aLLGa 1G aersl� awwae,w Sao J4sLG Gouat� !� . pmt $9 Caweae <br /> trt &War 1M%GJ4 the VGark kris de•2rLYed. 2"satu <br /> a�liaaslGa se staff <br /> In eataarliswoe Vita a"JOK"n Callose Or omme /a. 5k4 awd 1.0" a" the RLUV wraa ReSa7. " we at f s <br /> Jampla caiiiiinLT K*ue zMau Deride". <br /> j,a.,,ea i Los fit*-06 ass <br /> job Addreq �t''at_�- —�n f1J. r7r�l]j�11gr'. _ Cn1r���— �w.w��� r�'e'r r <br /> OwnafG Nem• �.. EG,. Address rna%• <br /> icansa f.t.AMMA CS.Ron Aw-An <br /> CsnTrGcfOr J%+��+�Irri'.ffirleln+ <br /> MEWELL OSTRLC'fON a pu • of Yel <br /> TY OF WELLIPUMP- Msi WrfrlC iill <br /> PUMP <br /> INST.%LLATION M SYSTEM REPAIR O OTHVI O /+ <br /> DLSTANCIE TO NEAREST: SEPTIC TAMIL SEWER LINES _ - DISPOSAL FLO. PROP. LINE _ <br /> FOUNDATION .r..�.^� NGRICULTURf WELL OTMW WfF.L PRS/$1.IMPfj Q <br /> JXTENOM USE TYPE OP WELL PItOBL.EM AREA CONSTRUCTION SP10FIC A37ONi � Q <br /> El lnduediel 0 Open Sow"- 7 Manes Dia.at wal Ewaestian I%a a - OIL d WON Cp�i <br /> 4 O&&.dPam �'-tfwv Typo al G�nO <br /> GWA <br /> I'l P&d1k �dw Ii W014 Dmxh of Gr"A Sear TV"« <br /> I I IrriywDen AL AOprea. D•Prh I I FASI rl Sudo=Sal Ins"w4d by <br /> ROO*r Vftfk Gane a TV"at ro N.P. Sim Wak Dana (� <br /> vm on"sofm O WO 0*""T �— b� rptb <br /> 1M VAUWtal a "1 <br /> 0800 7A t 1Y124r IMcviai b Dersk 'ICZ <br /> TYPE 4W S PTIC WORK: NEW INSTALLATION 1 1 REPAIRIADOITION 1 l of RUCTION I i Q m 1parTrair�led R Plebs Serer is <br /> ti <br /> kaetMlaeen wall Gar.•- III "I O0w <br /> Chwww at e01 b a"PM of 3 Hai: VLrawMr Wbb al WO <br /> SEIPM TAMIL O Type/MV co. NO. ConlpalrPw o <br /> PKG. TMATMENT PLT.d Megbod M CWP" <br /> Dbawce to Florwa: Won PrWWW L"�� C <br /> LEACHOM LINE O Ne.i Lwwh of linea Tatr1 lalrg111/aiee <br /> ALTER 560 O OWUM r w racer aL: Ww Feaweaeen PrePaetk Litre <br /> SEVAAG PITS I I 0"Kh �.w..-� Sim F w►�•r <br /> BUMPS LI OLswKs a frust: WMa Foundavon PnaP M Lina <br /> DISPOSAL PONIH 0 <br /> I hagdy CWWV that I hrM WOOMW On 3pg49@0Vn ana B,at tM Werk w#be daft in GccordN!ce.rich Sm JewpOn coumy GrdwUN IS. state N1111911�and <br /> twine.and raMdsbmM of the SW JGWJin CaraslT <br /> Nanta awrw ar iarrsed ageWs derAttttw car Pies dr 1010vol>i:-1%.lift what m PM Pedurnwift of The r.erk for wRMch!aria Per i 1Gwaw.1 arra/not <br /> employ any PWOun 00 Goch trrtr W,,48 to 0e00frta subject to wwkman s oww wnsaton%w a at Cam*ww."Com w-Ws hirirap or wt4-ea008elin0 0WOMI• <br /> aslr "' *0 fallmvirq:"I%,p ify rAAN in ft a•rlormanea of OW wort far whNh dig armit is aGalML I slash•rlrp0y pN'errM eadlfaet W te0rtlt+latr G+D XV011lwq• <br /> Tion%me of Ca off"a." <br /> T*00194" <br /> 0 inrrrcdMM. Ca>nww"eke"! an rpwwsilo. <br /> Title: r 7Cr�irr�. f �.��- Oar. <br /> SiElaer �. <br /> FOR DEPA RTIMERT YS!ONLY �.Q � <br /> /�pPlira~art AGp� - <br /> Ph or Great Irmserra I by Find Inspectian by <br /> Ada>filiavA Cmrrr+n W* 3 LC.COr+J f `Gf1 s r <br /> ippllcaut - iseturw all copies ta: San doaquio County Aubuc neattit Service■ <br /> 8ovirvew•etal isa th Pwrrrit/ierviC•% <br /> 445 H 3aa Jowmio. P 0 Box 2009, Sick%. CA 95201 * Zg01 <br /> wMF0 <br /> AYOUIGT OtrE -hwUwT MAL--TT6D w CK I RICIP1rED 9+l' T PolwT-Mo. L <br /> tel!/ l I <br />