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� <br /> ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN^o^ouwCOUNTY swvmowmENT*HEALTH DEPARTMENT 1mme.*AZEonoAVENUE'un*mOwcxo52n '(20m)"au-3*m <br /> NoN-REFuNoAsLE PERMIT CALL(2091954-7697 TIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> CROSS STREET It a,J APN <br /> GONTRACTO <br /> PHONE <br /> CONTRACTOR ADDRESS ___...____CITY/STATFaIP <br /> WATER TABLE DEPTH: .........._ ................. _................o GEOGRAPHICAL INFORMATION: uo*rdmmmm x_....................___.................. <br /> TYPE OF WORK: New INSTALLATION F.PAIFVAotxTtoN ENsiNEEA DEstGNEoJALTERxATtvE <br /> ve REPLACEMENT <br /> OUT-OF-SEAVICE SEPTIC SYSTEM DESTRUCTION <br /> 3 unamSErnAp rvpr-JMpo_ ..................................__.............__..................... o^PAo/TYmw wo+oow,^x,MENT�....._............ <br /> onnvNCs,umsmREsT` WELL ________ x pooNommw_______ it PROPERTY LINE -ft . <br /> Q LIFT STATION SIZE _.............TYPE mppvmp______ o ,xarxPLANT o SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ����....... ........... ����������� <br /> �9 LemCoumsa o us»ommo "upUe,����_ LENGTH opLINES It <br /> DISTANCE mNEAREST wsuo 1`0LwmATm* 2ft ,mPcnnu°eo <br /> � <br /> FILTER BED WIDTH It Lswa`x o oEPT^______________'' x <br /> DISTANCE n,NEAREST WELL_ ......... ....................n pmxNO^,ww_ ..........._....................-it PROPERTY LINE x <br /> 0 wmowoeo Wmm ........................... __-x LENGTH It uc,ry x <br /> DISTANCE mNEAREST WELL-----.--It FOUNDATION_ ... _ .................u PROPERTY LINE x <br /> 0 yospo Worm_-_.........._ n Lswux^ u u^pmft <br /> DISTANCE mNEAREST x FOUNDATION ft pnnpsnTY LINE It <br /> (3 DISPOSAL PONDS WIDTH ............................-_____it LEwaTH...... ....._........... n osrmIt <br /> DISTANCE mNEAREST WELL ft FOUNDATION ft PROPERTY LINE________ o <br /> m SEEPAGE PITS vtwuFn � w^mm _ft DEPTH it <br /> DISTANCE To NEAREST WELL It FOUNDATION A PROPERTY LINE <br /> on <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN AC�CUOR ItH SAN JOAGUIN COUNTY ORDINANCES, <br /> UIN <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOZ'll LIN <br /> ................. <br /> �v ------ <br /> Pisa <br /> SPECIAL PERMIT-Approved by <br /> Character of Soil Z�thof 3 Ft. Pill/Sump Soil Character: <br /> per <br /> PF R <br /> SC eoe�ed it/ <br /> te m Invoice It Permit 10# <br /> i Code INFO Cash Remitted Service Reg st# <br /> � <br /> 42-01 � ONSITE WASTEWATER TAnMNT SYSTEM PERMIT <br /> ~ <br />