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PLBG (9903-158)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 7�ki159 Cs't. c_ _ _ .i29iUu Date '� 7 Signature of Contractor % f OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( ) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions./' Date: ;.;. Applicant.. Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as.a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) % �� Date BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT 7 . ZZ c/ $1.4.10.0 JOB SITE t ' APN ADDRESS :12495 1}►VENIDA &Ii�.i'I W7A 773-232-021 OWNER CONTRACTOR / DESIGNER / ENGINEER 1.f1 QtJ1"-ITA 1:t7tlt `.rIii.{?Pl4;1:NT'r1.GP.�JC`/I vro( x', ,Sli `iaf: spliv1{:t, 78-493 Ceti;,1.E':!'tLlWIC0 84035 CARrl.eON RD. INDIO, CA 92201 LA o.1.1191'A CA 92251 mum i'Jl.s'siucr CA 92201 (7'{+nl;lji(i-27;�i C'.filid 31; USE OF PERMIT SEPTIC MiV41DON, SEWM CONNECT (LO -K1013 )>ROJECf tl jt4 C-OWRACT AMOUNT 1,d;:(3.001. a ES'. J 1AT4.!.",D CM, T OF t;�'iiWITH"C' ION MAW 1`Et2MIT FEF, SUAIN3e'1kV MLUNIBINO YEH -- NEWER 101-1NK14h-OW S311.4h3 SI 11; MI"'A►. ("ONSMU f(-1T.C')N ANI) PLAN CHECK $10 (1Q LESS PRE. PAID FEES $0 00 14)Trll.l't RAM' FEM 4il.iENOW I "tmo RECEIPT DATE ' BY , � I DATE FINALED I INSPECTOR INSPECTION RECORD OPERATION DATE. INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath - Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: I T4tyl 4 4 Q" P.O. BOX 1504 Building 52— 195 Yandoza78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Coachella Valley Land Co. Mailing Address 1-47 E. Tuhctuits Tfty #2 City Zip Tel. Falco Dorincf s 92263 1 322-1020 Contractor I Starr Construction ress City lZip I Tel. State Lic.I City & Classif. 387934 Lic. # 895 Arcn., tngr., Designer Address—T—Tel CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. , r .n•` v!E�.t L rr�! SdENATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec., 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter. Improve, demolish, or repair any structure, prior to its issuance also requires fhe, applicant Tor such permit to file a signed statement that he is licensed pursuant to the provisions of-lhe,Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or thathe is exempt therefrom, and the basis for the, alleged, exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). O 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building orimprovement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) 0 I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to,self-insure, or a certificate of Worker's Compensation Insurance, or a certified copytherepL,(Sec. 3800, Labor Code.) Policy No. Company __Z/ 11C r� d Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($ 100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any peon in any manner so as to become subject to the Workers' Compensation Laws of Cal ifornirsa. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is abuilding permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING: TYPE CONST. OCC. GRP. A.P. Number 773--233»441 Legal Description Project Description S «' • • 1 WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE Sq. Ft. 1410 Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Garage 4281 Peace 170• Estimated Valuation $75 r 505 PERMIT AMOUNT Plan Chk. Dep. 4Z!i Plan Chk. Bal. Z? 39.14 Const. 11104 a Uu Mech. 3 0 Electrical W • / Plumbing 1r�J S.M.I. • •� Grading Driveway Enc. ZV • U0 Infrastructure ♦ �� • TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 7/19Permit Validated by: Validation: 1 WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT (p $ UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. a FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT a GAS (ROUGH) METER LOOP GAR SO. FT. a POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO FT. a GROUT WATER HEATER WALL SO. FT. a FINAL INSP. DRINKING FOUNTAIN - SO. FT. (a WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ -$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTONDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 11 VENTILATION LAUNDRYTRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE. TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. (g, c BATH TUB LATHING r'' k SO. FT. g c WATER HEATER MAX. HEATER OUTPUT. B.T.U. SO. FT. RESID I'A c SEWAGE DISPOSAL SO.FT.GAR rg Vic HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. .SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ -$ LUMBER GR. FINAL INSP. ,,�� %f'C/eRAMING _ �-Vl/ LL._ FINAL INSP. ROOFING 7 c000 _ K/ U ,� �����! c REMARKS: 11 VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING r'' k MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS , GARDEN WALL FINAL 4 y �C�� z A P.O. BOX 1504 APPLICATION ONLY Building 7&105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner YAGLEI/ BUILDING: TYPE CONST. OCC. GRP. Mailing Address a A17 F 7—A./v4o iTZ WX V 'EP_ A.P. Number 7 73 — a3 Z -0 2/ City Zip Tel. AAl"f $POP/aG S z.— SZ Z - is is Legal Description I©T lo . ,lUA:e Ss- 41w Contractor Project Description ,5�,W,e4 V,04)S7WV0_7 Z0 1) ..2 �17 E 7r4W4k)rTL �Il tit st.-e a gZz4,2 3 z i -•o - State Lic. City & Classif. 3N7 ?3`4 Lic. # 8 9S Arch., Engr., Designer Address I Tel. City (Zip (State I Lic. # LICENSED CONTRACTOR'S DECLARATION n licensed under provision of Chapter 9 tc Mmencing with Section i Businessand�irof/essions Code, and-r�lcense Is 'n full force nd OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such' permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improvesthereon and who does such work himself or through his own employees, Provided that such Improvements are not intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property -who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date owner WORKERS' COMPENSATIO14 DECLARATION I hereby affirm that I have a certificate,of co sent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified,copy7thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Ce rf ed copy is er b -furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's 'Name Lender's Address This Is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I cer illy that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for Inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING DIVISION Sq. Ft. No. No. Dw. Size /yr/p Stories / Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT Plan Chk. Dep. 2 �� Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL —7- 7) AMOUNT REMARKS %6w__CASH i TOTAL 1 215,00 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR N. Issued by: Date Permit Validated by: Validation: . - i CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. ® BONDING YARD SPKLR SYSTEM ' FOR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APP.IEQUIP. DRINKING FOUNTAIN SQ FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® 3/ac HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF 4-4 SCHOOL FACILITY FEES C�7J NOTICE: THIS DOCUME T CANNOT NOT BEDUPLICATED. � TO: City of La Quinta DATE: `C3 Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 s' This is to certify Vat , developer of which is located at — l/ within this District, has paid school Yacility fees imposed pursuant to the authority generated Gover ment Code Sectiop 53080 in 4eidRnti of s 10,,�7a•�soc � covering a total of Zo �% Zn ,) uare feet of ( )a or ( ) industrial/commercial development and that building permits for this footage in this d velopment may now be issued by your jurisdiction. for DESERT SANDS -UN ED S OL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting 0 Gold - Developer (10)-37 IE 04 z O FZ U W U) m z O P U w r, U) `1 lr Q W U w U) .71 - COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION �� J PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM Applicant: Submit this_form. with four copies of a scaled plot plan (1-20 scale) drawn to County specifications required on the attached check list. A non-refundable filing fee of 3ff&is,required when the application is submitted. Check must be made payable to the County of Riverside. Building Department Application Log N Name (Owner. Agent. Contractor. Etc.) 6rAA?A¢ C.0 A,s7R0.a7ia✓ Mailing Address �V7 L TA/Y_Qtc_i_r� �vVa�/aL City // >�ZAf S,Pe/AJGS Slate C� A Zip Code 9Z Z G 7, Telephone 3 a z -/o o 'Job Property Address �%� 1a�� 'Cy�lypot•Gomin3nfly 'Legal Description of Properly. (Lot. PM. TR) - S'3 /9S 1"A�'Nim Z ,4 4 rq QdiAu It A dT / O .OL fjj 44 v 'Assessor's Parcel No Water Ageri�,,0_ .1 fX Use Per / !.! � 'Gtti( �lannr� Case N Lot Size 7 / — 3 — Z of r� I �✓ X ,!% j �5-r IR , CT SFD. MH Site Preparation Etc /� igf ApptiCanl Dale $1'9_ 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date Certification of Existing S.D. System required. ❑ Yes ❑ N/F WOCB Clearance required. ❑ Yes P -No i Soils feasibility report required. El Yes / if Special feasibility boring report required. ❑ Yes 0 Nd .1 Detailed contour plot plans required. ❑ Yes O No'l { i Staff Specialist approval required. ❑ Yes © No Lot Inspection Date t Soils/boring report by f ' / Project # Date-,, Soils Map Page /d r Soil Type �G Approved by ��.i/ 2--� Dated Type of System: !/ No. of Bedrooms (1) Septic Tank Rate Required ElIJ Existing Sew ❑ Additional ❑ Replacement �� 4v Gals. /Soil (2).,each line sq. ft. Sidewall allowance Install �_Line(s) Ft. Long, Leached Sq. (Bo rr>,trench area) \ ft. rock/ Sq. Ft. Ft. wt ewvi min. inches Ft. of b oin..�,� per running ft. ® /A rock below drain lines` area Leach lines/bed-special design for slope: Applicayle—,__­- (3) Pit Diameter / No. Pits Pit BI , Seepage Pit total depth © 6' 1 /i� Max. allowable depth N/A Overburden factor I� r 1/ I-) This application is approve i GrNeeMor the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements the set forth in Section B a ove. A building permit is necessary for installation of the above -designed system. M,rr J 1) Septic tank and sewer lines must be 50' from any wells/ �' r� f� Lri. °�'-,, Leach lines must be 100' min. from any wells including expansio area L� ��vf ? j - ex .7 (3 Seepa a pits must 150' min. from any wells expansion area(a% /including �j1CV, /be r RECEIPT NO. IOUIssued by 5� Dai 7 District: ❑ Riverside r Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH SAN 122 (Rev 8187) J' 5 o� �i .M r q► FIr.E OF E. LEON SPAUGY Q AGRICULTURAL CONIMISSIONER J s )AMES 0 WALLACE AN AsS:STANr COMMISS10'(P �S , �`j WEIGH ITS & MEASURES CLENIENSt6 E VENISTE �,— 49-613 Ilwy 86, Suite 8-12 4i,�Mtoo0,4,1 'Coachella, CA 92236 '4 Y p 1 69 619-342-8291 DATE I— 12 4� CASE W. DEVELOPER'S NAME: �j t- R rr- CO NC_J LL C-1 c) j ADDRESS: `I % 'T 'Z LjA 2- TELEPI LONE: (-� (� l 302 /020 �31gS r�l,��.►c�zh �.� c�..�-;�►}� A -t PIrA,,, Dear Developers After reviewing your landscaping plans, 'all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ frun plaint material listed, this office must be notified imnediately. l Thank you for protecting and preserviuig the Coachella Valley's pest -free environment. Agri tural Calmissioner s Office cc: Indio and Riverside Office 0