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PLBG (11-0959)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4t�v " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 11-00000959 Owner: Property Address: 52220 AVENIDA MENDOZA URIBE LUPE APN: 773-273-001-22 -000000- 52220 AVENIDA MENDO Application description: PLUMBING LA QUINTA, CA 92253 D Property Zoning: COVE RESIDENTIAL Application valuation: 13660 Contractor: i nnnli��n* Architect or Engineer: US HOME SERVICES 345 CLOVERLEAF DRIVE #B IRWINDALE, CA 91706 �® (626)333-2001 ry Lic. No.: 768707 LICENSED CONTRACTOR'S 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 Cl s: C36 C17 C6 LicenseNo.: 768707 Date. C ractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and.Professions Code) or that he or she 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 _ 1 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the 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 or she did not build or improve for the purpose of sale.l. (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ( 1 I am exempt under Sec. . , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9106111 Q=P U 6 2011 LA WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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. –Y-lave 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 and policy number are: Carrier COMMERCE & IND Policy Number WC007171491 _ 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 1 should become subject to the workers' compensation provisions. of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. te: can 7 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions. and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 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 county ordinances and state laws relating to building construction, and hereby authorize representatives of this cou yy too enter upon the above-mentioned property for inspection purposes. 'OW. -Y4 i Sign re (Applicant or A 1JE_� . Application Number . . . . . 11-00000959 Permit PLUMBING Additional desc . Permit Fee 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation 0 Expiration Date 3/04/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------7------ Special Notes and Comments REPLACE 2 BATH TUBS AND 2 SHOWER VALVES. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due --------------------------- Permit Fee Total ---------- 18.00 -=------------------ .00 .00 18.00 Plan Check Total 4.50 .00 .00 4.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 23.50 .00 .00 •23.50 LQPERMIT Bin #.... , .., .. Coty of La Quinta . . Building & Safety Division P.O. Box 1504,78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permf[ # Project Address:p. Owner's Name: "),e— CA. A.P- Number: Address: 0 h Legal Description: City, ST, Zip: L0. C 'Z ZJ Contractor: -e ,e Address: C' 6 Lr ,� �1 D r --- Telephon : d ��.�- S?� Project Description: "� p v IMMUNE a4 r IQC< City, ST, Zip:l f.�) i � - [ I %C� l� CI'''tzc�.� �w w�e� �/ J C r,c k c wkA.(. t Telephon / �� "t��• .' w :4� .. State Lie. # :769-7D-7 City Lie. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lie. /� Name of Contact Person: Gv�D[ •» ; "" ° Ie Construction Type: Occupancy: Project type (circle one): New Add'n ter epair Demo Sq. FL: # Stories: # Units: Telephone # of Contact Person( 0 Estimated Value of Project: 1 �p loD APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calks,Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading planARew, ready for corrcctioasfissne FJedritxl Subcostactor ListContact Person Plumbing Grant Decdicked up S.M.I. H.O A. Approvalesubmitted Grading IN HOUSE:- Review, ready for correctiomMssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. APpr Date of permit issue School Fees Total Permit Fees Tihf 4 4 a" Building Address 52-220 Mendoza Owner David miller Mailing Address 1719 S. t City ZipTel. I YC - P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Contractor I Address „ Zip ITel. State Lic. I City & Classif. 425381 Lic. # Arch., Engr., Designer Address Tfel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereb affirm that Iwam licensed under provisions of Chapter 9 (commencing with Section 7000) of ivision 3 of. the BZInness and Pr fessions Code, and my lic6nyse is in f�([Il forcte and effect._ i St.ri \C _SIGNATURE DAT 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 rile a signed statement that he is licensed pursuant to the provisions or the 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 ($500). ❑ 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, 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 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.) O 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 copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ 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 (S100) valuation or less.) I certify that in the performance of Ing 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 certify that I have read this application and state that the above information is correct. 1 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• -entioned property for inspection purposes. I - Date No. 87437 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 773..773001 Legal Description Project Description Sq. Ft. Size 1467 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $81,4661 PERMIT AMOUNT Plan Chk. Dep. 250.10 Plan Chk. Bal. 229.03 Const. 554.00 Mech. 55.50 Electrical 109,45 Plumbing 165. " S.M.I. 5.74 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1,797,51 TOTAL $3 208.03 REMARKS nnc s n-� S z, 73 R'L�znuq�; 44 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 329/goPermit Validated by: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. @ WALL SO. FT. ® SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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. ®c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL D, b `- p 9 1 O 1d SO.FT.GAR ® 3/4c HOUSE SEWER VENTILATION 1 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 7 Q UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 7 9� ROUGH PL MB. BONDING HEATING (ROUGH) STORAGE TANK FORMS S IC TA K ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL % Zj 9� GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ -Plus-x$-=$ LUMBER GR. FINAL INSP. 0 FRAMING �d � FINAL INSP. ROOFING /i]��/ �/? f/GO 7ry/A�-{/' D, b `- p 9 1 O 1d REMARKS: VENTILATION 1 FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND� f% Q FINISH GRADING FINAL INSPECTION CERT. OCC. Desert Sands Unified School District CERTIFICATION OF PAYMENT //�� OF NOrt^E. SCHOOL FACILITY FEES TO: City of Laojuholr>rtA ^^ CANNOT Department of Commt6 ?yrrQevelopm n 78-105 Calle Estado La Quinta, CA 92253 DATE: %OQ This is to certif that 1''w "'`�' ��I.�WV "�l/vA-r./ , developer of chs� located at - "thTn�n 2 this District, has paid school facility fees imposed pursuant to the CTU a horit g n at b10 Gov nment Code Se on 5OP5 in the unt of S i cov ring a total of square feet of (residentia industrial/commercial dev lopment and that builpermits for this footagein this development may now be issued by your jurisdiction 1 @ 150 2_ dJ ipfor DESERT SANDS IFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer 0)(,;Ir I l � 3 (10)-37 AMENDMENT TO INSTRUCTIONS FORESITE ESCROW, INC. DATE March 13, 1990 ESCROW No. 1 -3023 -MH The previous instructions in this Escrow are hereby modified or amended in the following particulars only: The vesting herein is.hereby changed to read as follows: David Ross Miller, a married man, as his sole and separate property and Kevin J. Martin, a married man,.as his sole and separare property Escrow holder is hereby authorized and instructed to accept into escrow the sum of $10,000.00 and upon the.clearance of buyer check and upon the receipt of all escrow instructions signed by buyer and seller you are authorized and instructed to release said $10,000.00 payable to the order of the seller herein, prior to the clo'se.of escrow. - It is the sellers intent.to pay said $10,000.00 to the existing first Deed of Trust holder as partial payment on the existing lien. The escrow closing date is hereby changed to read on or'before April 6, 1990. In lieu of the extended closing date buyer agrees*to pay interest to seller the interest accruing on the balance of the first Deed of Trust, less the $10,000.00 released funds, from March 6, 1990 to the date of the close of escrow. It is hereby agreed by and between buyer and seller that the said $10,000.00 released funds are to be non-refundable unless this escrow fails to close due to any fault of the seller. David Ross Miller Kevin J. Martin Dan Featheringill Cheri Lynn Featheringill TO Courtesy Escrow Service 72-880 Fred Waring Dr.', Ste. C-13 ESCROW INSTRUCTIONS Palm Desert, Ca. 92260. 619-346 8154 Buyer will hand you the sum of $9750.00, of which $500.00 has been deposited herein, and will execute documentation called for below to complete purchase price of $19,500.00. and will deliver to you any Instruments which this escrow requires shall be executed by me, all of which you are instructed to use provided that on or before March 8, 1990 you can order a policy of title Insurance with the usual title company's exceptions, with a liability In the amount of the total consideration covering Lot 19 in Block 95 of Unit No.11, Santa Carmelita at Vale La Quinta Jeannie Robinson Escrow Officer 14001-2 Escrow Number January 30, 1990 Dale PAID OU (SIDE OF ESCROW CASH THROUGH ESCROW $ 9,750.00 ENCUMBRANCES OF RECORD NEW ENCUMBRANCES 9,750.00 TOTALCONSIDERATION $19,500.00 as per map recorded In.book * 18 page(s) 75 of maps in the office of the County Recorder of Riverside County, State of California showing title vested in: DAVID ROSS MILLER ( COMPLETE STATUS AND VESTING TO BE FURNISHED BY BUYER.) Property Address: Vacant Land — Parcel No. 733 232 004 (Not verified) FREE FROM ENCUMBRANCES EXCEPT: (1) General and Special taxes, not delinquent, for the fiscal year 19 90/91 including any special district levies, payments for which are Included therein and collected therewith, together with any reassessments due to non- compliance with any California Stale Statute. (2) The lion of supplemental taxes If any assessed pursuant to Chapter 498 of the State of California Statute of 1983. Buyer is aware that property taxes are subject to reassessment as of the date of recording of the Grant Deed. These taxes will be buyer's full responsibility. (3) Assessments and bonds, if any, not delinquent to be ( XXX ) paid by seller, ( ) assumed by buyer. (4) Any covenants, conditions, restrictions, reservations, rights, rights of way and easements of record, or in deed to file, and any EXCEPTION of water, minerals, oil, gas, and kindred substances, on or under any said land, now of record, or in deed to lite. (5) DEED(S) OF TRUST now of record, unpaid balance of principal approximately $ None the terms of which are known to the parties hereto. (6) DEED OF TRUST to record in the amount of $ None Execution o1 loan documents shall be deemed approval of the terms thereof. You are to follow the Instructions of the lender through this escrow. m PURCHASE MONEY DEED OF TRUST executed by THE VESTEE securing Note for $ 9, 750.00 in favor of Vernon R. Avery, Sr., and Nancy J. Avery, husband and wife as joint tenants. or order, dated during escrowwilh interest at Nine percenter annum, from date endorsed payable at maturity al La Quinta, California CALIFORNIA,Idrlrfclp!a{�p(�j(i�ef�q}d��t/n(dfA/////////,E 6(7�(� fg9t✓V►��14./////////////////////d'ay/oib�le�r�////////////////�///drfEbf,/b�ei�FTlrfg�ON OR BEFOR0 days from date of close of escrow,-ai'-which time :che hien unpaid principal balance, plus accrued interest shall become due and payable. The Buyer and Seller are not relying on Escrow Holder to make any determination if this note will be effected by the Federal Law regarding imputed interest. Obtain STATEMENTS indicating unpaid balances of principal and interest on Deeds of Trust now of record, and if same should siTow to be more or less than the amount shown herein, you are to adjust the CASH THROUGH ESCROW/PURCHASE MONEY DEED OF TRUSTfTOTALCONSIDERATION. Not applicable None water shares to be transferred to buyers. Bills and assessments to be paid to close of escrow based on statement from water company, if shares are transferred. The following adjustments ONLY, required in this escrow: PRORATE taxes, based on Info. furnished by seller/Title Co.,11416 Ea/Ttfa, IrAW11,4 <t(/ / rmrf�1119�'1p4�/'9rY/91'�/�'71�Se19�1�>�91V9q/Y�J�,to: Close of Escrow pounds, if any, are to be re mbursed to the seller in. cash by the buyer unless otherwise provided herein: Endorse interest on note to accrue from date of close of escrow If note and trust deed drawn by Escrow Holder. It required, complete any such note as to payment and/or due dale above signature of Trustor, at close of escrow. THESE INSTRUCTIONS ARE CONTINUED ON PAGE 3 EACH PARTY SIGNING THESE INSTRUCTIONS HAS READ THE ADDITIONAL ESCROW CONDITIONS AND INSTRUCTIONS ON THE REVERSE SIDE HEREOF AND APPROVES, ACCEPTS AND AGREES TO BE BOUND THEREBY AS THOUGH THE REVERSE SIDE HEREOF APPEARED OVER THEIR SIGNATURES. ALL PARTIES SIGNING THESE INSTRUCTIONS HEREBY INDIVIDUALLY OR JOINTLY ACKNOWLEDGE RECEIPT OFACOPY OF. THESE. IjVSTRUCTIONS._ _ MAIL TAX STATEMENTS TO: - address below Buyer's Buyer's Signature David Ross M11ter Signature Address 1719 So Tremont- Oceanside Ca 92054 Phone 619=967 1588 The foregoing terms, provisions, conditions and instructions, and those on the reverse side hereof are hereby approved In their entirety and concurred In by me. I will hand you necessary documents called for on my part to cause title to be shown as above, which you are Instructed to deliver when you hold for my account the money and instruments deliverable to me under these Instructions within the time as above provided. You are Instructed to pay bonds. assessments, lazes, and any liens of record to show title as called for. Pay transfer tax as required. See separate Instructions for commission, it any. Seller's Seller's Signature Signature Vernon R. Avery, Sr.. Address 52-066 Avenida Martinez, La Quinta, Ca. 92253 No. 1 Escrow Instructions 1/81 Nancy J. Avery Phone 619-564 1521 PAGE 2 ADDITIONAL ESCROW CONDITIONS AND INSTRUCTIONS 1. All funds received in this escrow shall be deposited with a State or National bank with other escrow funds. Make disbursements by your check; checks not presented lot payment within six months after dale are subject to service charges In accordance with your schedule in effect from time to time. Make all adjustments and prorations on the basis of a 30 day month. "Close of Escrow" is the day Instruments are recorded. All documents and funds due the respective parties herein are to be mailed to the addresses set out below their respective signatures, unless otherwise instructed. Our signatures on any documents and Instructions pertaining to this escrow indicate our unconditional approval of same. Whenever provision is made herein for the payment of any sum, the delivery of any Instrument or the performance of any act "outside of escrow;' you as Escrow Holder shall have no duty therefore, shall not be concerned therewith and are specifically relieved of any obligation relative thereto. 2. Seller In a sale escrow, or borrower in a loan escrow guarantees and you shall be fully protected in assuming that, as to any Insurance policies handed you, each policy Is in force, has not been hypothecated, and that all necessary premiums therefore have been paid. You will, as my agent, assign any fire and other insurance policies handed you or that Beneficiaries Inform you they hold. Deliver assurances of title, and fire or other Insurance policies, if any, to holder o1 senior encumbrance or his order, or If there be no encumbrances, then to the order of buyer or lender. Any policy of title Insurance called for herein may be used for the benefit of all parties In Interest, may be procured by you from any title company operating in the county where the property is located, and will be subject to exceptions and conditions in such company's regular printed forms. The selection of the type of title policy to be obtained including the dollar amount and physical, fill@ and other conditions covered or excepted from coverage thereunder has been made by the parties based upon their Independent evaluation and has not been influenced by or based upon any representation of the Escrow Holder. These Instructions may be executed In counterparts. All such counterparts together shalt constitute one and the same document. You are hereby authorized to deposit any funds or documents handed you under these escrow instructions, or cause the same to be deposited, with any other escrow company, bank, lending Institution, or title company In the event such deposit shall be necessary or convenient to carry out The Instructions set forth in this escrow, subject to your order. You are hereby given a Den upon any property held by you for me, whether held in this escrow or otherwise, for any and all escrow fees, expenses, costs, attorney's fees, losses and other Ilabllities Incurred by you and arising out of, connected with or Incidental to this escrow or any other escrow to which we are a party. You may deduct from my net proceeds any amount I may owe you in any other matter. You may destroy these Instructions and all other Instructions and records in this escrow at any time after No years from close o1 escrow. 3. In consideration o1 your undertaking to act hereunder, I agree to pay, when called upon by you to so do, for: all services performed for me, together with all charges, expenses and costs Incurred or paid for me by you unless the written instructions herein provide to the contrary. I also agree to pay a reasonable escrow fee for the services contracted by me to be rendered by you. I agree that said charges for expenses and fees may be apportioned between us In a manner which, in your sole discretion, you consider equitable, and that your decision in that regard will be binding and conclusive upon us. Owner's policy of title Insurance Is a service of the seller. Should an escrow with a contingency not be completed because of the failure of the contingency then each party agrees to pay one-half o1 the escrow costs and expenses. In the event of failure to pay fees or expenses due you hereunder, on demand, I agree to pay a reasonable fee for any attorney's services which may be required to collect such fees or expenses. 4. You shall be under no obligation or liability for failure to Inform me regarding any sale, loan, exchange, or other transaction, or facts within your knowledge, even though same concern the property described herein, provided they do not prevent your compliance with these instructions, nor shall you be liable for the sufficiency or correctness as to form, manner of execution, or validity of any Instrument deposited, nor as to Identity, authority, or rights of any person executing the same. You shall not be required to lake any action In connection with the collection, maturity or apparent outlaw of any obligations deposited In this escrow, unless otherwise instructed. Your liability as Escrow Holder shall be confined to the things specifically provided for in my written instructions In this escrow. 5. If the conditions of this escrow have not been compiled with prior to the expiration of time provided for herein, or any extension thereof, you are nevertheless to complete the escrow as soon as the conditions, except as to time, have been complied with unless written demand executed by a party to this escrow shall he" been made upon you not to complete it, or unless such demand creates a conflict in the Instructions. If such written demand Is received, you may proceed In accordance with the provisions of paragraph 7 hereof. 6. Your duty to act as Escrow Holder does not commence until these instructions, signed by all parties, are received by you. Until such time either party may unilaterally cancel and upon request delivered to you, the party may withdraw funds and documents he previously handed to you. in the event of non -completion of this escrow within 60 days of originally scheduled closing date, or any written extension thereof, seller and buyer will, if requested by Escrow Holder, deposit instructions to cancel the escrow and deduct cancellation lees, costs and expenses from funds held. Unless written Instructions, contained herein, provide the contrary, you may, at your election, assess the accounts of any of the parties hereto with said charges andlor you may prorate the same as you deem proper. Buyer agrees, on demand, to deposit cashier's, certified check or cleared funds to close escrow. 7. Should you become aware of any conflicling demands or claims with respect to this escrow or the rights of any of the parties hereto, or any money or property deposited herein or affected hereby, you shall have the right to discontinue any or all lurther acts on your part to be performed hereunder until such conflict Is resolved to your satisfaction, and you shall have the further right to commence or defend any action or proceedings for the determination of such conflict. 8. The parties hereto jointly and severally agree to pay all costs, damages, judgements and expenses, including reasonable attorneys' fees suffered or Incurred by you, arising out of, connected with, or Incidental to this escrow, including, bud without limiting the generality of the foregoing, a suit in Interpleader brought by you. In the event you file a suit In Interpleader, you shall be fully released and discharged from all obligations further to perform any and all duties Imposed upon you In this escrow. 9.11 a party to this escrow unilaterally assigns or orders the proceeds o1 this escrow to b9 paid to other than the original parties to this escrow, such assignment or order shall be subordinate to the expenses of this escrow, liens of record on the subject property, and payments directed to be made by original parties together. 11 the result of such assignment or order would be to leave the escrow without sufficient funds to close, then you are directed to close nevertheless, and to pay such assignments or orders only out of the net proceeds due except for such assignments or orders, and to pay them in the order In which such assignments or orders are received by you. You are to furnish a copy of these instructions, amendments thereto, closing statements and/or any other document deposited In this escrow to the tender or lenders and/or the real estate broker or brokers Involved In this transaction upon request of such lenders or brokers. In the event of an assignment or transfer of Interest by operation of law, with or without the approval or consent of any or all of the parties hereto, you shall retain the right to deduct any and all escrow costs, fees and expenses provided for herein from said assigned or transferred funds, properties or rights, said assignment or transfer notwithstanding. 10 You are not to be concerned with the giving of any disclosures required by federal or State law, specifically but not exclusively, California Civil Code Section 2956 of. seq. regarding extensions of credit by vendors In residential sales, RESPA (Real Estate Settlement Procedures Act), Regulation Z (Truth in Lending disclosures) or other warnings, or any warranties, express or implied. Neither are you io be concerned with the effect of zoning ordinances, land division regulations, or building restriclions which may pertain to or affect the land or improvements that are subject of this escrow. You are not to evaluate this purchase, sale, ban, or other transaction as If pertains to Article XV, California Constitution, "Usury': The parties hereto acknowledge that any loan involved In this escrow may not be exempt from the current interest rate limits contained in Article XV, California Constitution. You bear no duty to make this determination to interpret this provision, or to give any warnings or any warranties, express or implied to any party to this escrow; and each party to this escrow is hereby advised to seek the advice of legal counsel regarding possible usury limitations. 11. All parties are aware that under California Civil Code Section 1102 through 1102.14 effective January 1, 1967, the Seller of real property containing one to four residential units is required to furnish to the buyer a completed "Real Estate liansfer Disclosure Statement" prior to transfer of title. Escrow Holder has no further duty or performance as pertains to the Real Estate ltanster Disclosure Statement and is relieved of any and all liability herewith. 12. The Foreign Investment in Real Property Tax Act of 1986 as amended by the Tax Reform Act of 1984 places special requirements for tax reporting and withholding on the parties to a real estate transaction where the transferor (Seller) is a non-resident alien or nondomestic corporation or partnership or Is a domestic corporation or partnership controlled by non-resident or non-resident corporations or partnerships. The parties to this transaction are seeking an attorneys, accountant's or other tax specialist's opinions concerning the effect of this Act on this transaction and are not acting on statements made or omitted by the escrow or closing officer. Buyer and seller herein relieve Escrow Holder from any and all liability, obligation or responsibility with respect to advising the parties as to the requirements of Internal Revenue Code Section 1445, determining whether the Seller is a foreign person, whether any affidavit executed In connection with said code section is accurate, obtaining any exemption from withholding, or withholding any sums pursuant to said code section. r • PAGE 3 Escrow No. 14001-2 You are instructed to assess the Buyer and Seller with the following costs which include but are not limited to: SELLER'S COSTS - Seller's escrow fee, preparation of the Grant Deed, Documentary Transfer Tax Stamps, Recording Fees, Title Policy, Demand Statement(s), Notary Fee. BUYER'S COSTS - Buyer's escrow fee, preparation of Note and Deed of Trust, Recording Fees, Bene- ficiary Statement(s), Loan Tie In Fee, Notary Fee. All parties herein acknowledge that Courtesy Escrow Service is required to report this sale to the IRS as per the Tax Reform Act of 1986. The Seller(s) are required by law to provide Courtesy Escrow Service with their current taxpayer identification number. The closing of this escrow is contingent upon seller(s) depositing into escrow a completed and signed Seller's Certification, unless the Seller is a corporation or government entity. Escrow Holder is to charge the account of the Seller for the cost of same. Buyer will furnish Escrow Holder with a completed and signed Preliminary Change of Ownership Report, prior to close of escrow. In the event said report has not been completed to the satisfaction of the County Recorder's Office, or Buyer fails to furnish Escrow Holder with said report, a $20.00 fee will be charged to the account of the Buyer as assessed by the County Recorder. In the event this escrow has not closed within one (1) year from the date of close of escrow as set out on page one (1) of these instructions or any amended date, a hold open fee of $25.00 per month shall be assessed against any funds deposited herein. This fee shall be in addition to any other escrow fee which Escrow Holder may assess the parties hereto. In the event any funds remain in this escrow one (1) year after the close of escrow a hold open fee of $25.00 per month shall be assessed against said funds. THE FOLLOWING IS ENTERED INTO ESCROW AS A MEMORANDUM ONLY WITH WHICH ESCROW HOLDER HAS NO FURTHER DUTY OR PERFORMANCE: In accordance with the State of California Health and Safety Code Section 13113.8 all single family dwellings must have an operable smoke detector approved and installed in accordance with the State Fire Marshall's regulations and any local ordinances, as applicable. According to the requirements as set forth in the regulations, it is the responsibility of the Seller to install said smoke detector and hand to Buyer a written statement outside of escrow indicating that the dwelling has an operable smoke detector and therefore is in compliance with the law. Not applicable to this transaction. ADDITIONAL INSTRUCTIONS Seller's Buyer's Signature Signature Vernon R. Avery, Sr. David Ross Miller Seller's Buyer's Signature Signature a1PaW3 Nancy J. Avery Sale Escrow Instructions Karjc? .-'errin _scrow Officer FORESITE ESCROW, INC. 73 -7 10 EL PAS EO, SUITE 3. P.O. DRAWER 3760 PALM DESERT, CA 92261-3760 (619) 341-4493 FAX (619) 341-0255 Ne have handed broker the sum of $500.00 which broke will deposit herein and will hand you an additional $19,500.00 and funds sufficient to comply with these instructions, all to apply toward a total consideration of $20,000.00, ind will deliver to you any instruments which this escrow requires shall be executed by me, all of which you are nstrucled to use provided on or before Mar . 5, 1990 you hold a policy of Idle insurance vith the usual title company's exceptions, with a liability equal to the total considerations herein covering 1 -3023 -MH Escrow Number January_ 15,•1990 Dale Paid outside of Escrow Cash through Escrow Encumbrances of Record Encumbrances of Record New Encumbrances Total Consideration .Jot 22 of Block 101 Santa Carmelita at Vale La Quinta Unit No. 11 ks per map recorded in book 18 page(s) 75 of maps in the office of the County Recorder of Riverside County, Calif. Memo: Property Address: Unimproved property ) Ihowing title vested in: David Ross Miller, exact vesting of title to be determined in ascrow by buyer. :REE FROM ENCUMBRANCES EXCEPT dNLY THE ITEMS NUMBERED BELOW: 1) General and Special taxes for the fiscal year 19 8 9 , 19 9 0 , which are not delinquent as of close of escrow 2) The lien of supplemental taxes, if any, assessed pursuant to Chapter 498, Statutes of 1983, of the State of California 3) Bonds/Assessments: 141 4) Covenants, conditions, restrictions, reservations, rights, rights of way, easements, and the EXCEPTION OR RESERVATION OF WATER, OIL, GAS, MINERALS, CARBONS, HYDROCARBONS OR KINDRED SUBSTANCES ON OR UNDER SAID LAND, now of record, if any. INSTRUCTIONS• �guyer to pay all cash for the subject property. Existing -Bonds and Assessments on subject property, if any, are to be paid cur:r.erit by.seller and the balance of said Bonds and Assessments, if any, are tv"be assumed by the buyer; which said items are included in the annual proeprty taxes. Escrow -feeds to be split 50/50 between buyer. and seller. Seller to pay for the owners policy -of title insurance and the documentary transfer tax. This escrow is subject to buyer approval of•the preliminary title report within.seven (7) days of buyers receipt of sanle.In the event escrow holder hasynot received written notice of buyers disapproval of said item within said seven days, said item will be deemed approved and this contingency removed in its entirety. All parties signing this agreement hereby acknowledge receipt of a copy of these instructions Prorate taxes based on latest available lax bill as of close of escrow Prorate insurance handed you as of none or buyer will hand you new insurance at his option. Prorate Homeowner's Association dues as of none Prorate interest on loans of record as of none Prorate rents and adjust deposits as of none based on rent statements handed you. Any rents in arrears are to be disregarded in your prorations. none Credit seller and debit buyer the amount of impounds, It any, as disclosed by beneficiary statements from the holders of the loans of record. none I/We agree to pay escrow fees and charges as charged. EACH PARTY SIGNING THESE INSTRUCTIONS HAS READ THE ADDITIONAL ESCROW CONDITIONS AND INSTRUCTIONS ON THE REVERSE SIDE HEREOF AND APPROVES, ACCEPTS AND AGREES TO BE BOUND THEREBY AS THOUGH THE REVERSE SIDE HEREOF APPEARED OVER THEIR SIGNATURES. Buyer's Signature �`^-- — Buyer's Signature David Ross Miller v�y — Address—. _--.-- -- Phone-_----_ The foregoing terms, provisions, conditions and instructions, and those on the reverse side hereof are hereby approved and accepted in (heir entirety and concurred in by me. I will hand you necessary documents called for on my part to cause title to be shown as above, which you are authorized to deliver when you hold or have caused to be applied Finds W lor!h 00\111'4 Ih®IIIna �hsv� tlrpvidedt NY yow Ol3snln GIt�qu, my I( oldillg Im, snilp^5 Igf t APTI6g Q! Wl@ �5 u.1!9d !pl V010 -f gr no! !his gscrq�f is consummated; except (hose the buyer agreed to pay:You are hereby authorized to pay bonds, assessrnenis, lazes, and any liens of record; including prepaymenl penaliles, If af1v, IQ snow 11119 as called ler. Ray pgournanlaty Iranafef lar on dead roti ro.Awlfad, Pay commission as follows $ see separatroe- commission instruction Seller's Signature_ C55 Daft Featheringill Seller's Signalure_ Address--. __— -------�-- -- -- --.. - i Cheri Lynn —, - --------_•— Phone_ Featheringill PAGE 2 ADDITIONAL ESCROW CONDITIONS AND INSTRUCTIONS Your duty to act as escrow holder shall not commence until these instructions, signed by all parties, are received by you. Until such time either party may unilaterally cancel and, upon written request delivered to you, a party may withdraw funds and documents such party previously handed to you. All funds received in this escrow shall be deposited with a State or National bank with other escrow funds. Make disbursements by your check: checks not presented for payment within six months after date are subject to service charges in accordance with your schedule in effect from time to time. Make all adjustments and proratings on the basis of a 30 day month. "Close of Escrow" as used in this escrow means the date on which documents are recorded, unless otherwise specified. All documents and funds due the respective parties herein are to be mailed to the addresses set out below their respective signatures, unless otherwise instructed. Our signatures on any documents and instructions pertaining to this escrow indicate our unconditional approval of same. Whenever provision is made herein for the payment of any sum, the delivery of any instrument or the performance of any act "outside of escrow;' you as escrow holder shall have no responsibility therefor, shall not be concerned therewith and are specifically relieved of any obligation relative thereto. You shall not be responsible or liable in any manner for the sufficiency or correctness as to form, manner of execution or validity of any documents deposited in escrow, nor as to the identity, authority or rights of any person executing the same, either as to documents of record or those handled in this escrow. Your duties hereunder shall be limited to the safekeeping of such money and documents received by you as escrow holder, and for the disposition of the same in accordance with the written instructions accepted by you in this escrow. You shall not be required to take any action in connection with the collection, maturity or apparent outlaw of any obligations deposited in this escrow, unless otherwise instructed. 4. Seller represents and warrants, and you shall be fully protected in assuming that, as to any insurance policy handed you, such policy is in force, has not been hypothecated, and that all necessary premiums therefore have been paid. You will transmit for assignment any insurance policy handed you for use in this escrow, but you shall not be responsible for verifying the acceptance of the assignment and policy by the insurance company. ESCROW HOLDER WILL MAKE NO ATTEMPT TO VERIFY THE RECEIPT OF THE REQUEST FOR ASSIGNMENT BY THE ISSUING COMPANY. You are hereby placed on notice that if the insurance company should fail to receive said assignment, the issuing company may deny coverage for any loss suffered by Buyer. IT IS THE OBLIGATION OF THE BUYER OR HIS REPRESENTATIVE TO VERIFY THE ACCEPTANCE OF THE ASSIGNMENT OF THE POLICY BY THE ISSUING COMPANY. 5. Deliver assurance of title, and insurance policies, if any, to holder of senior encumbrance or his order, or if there be no encumbrances, then to the buyer or his order. 6. In the event that the conditions of this escrow have not been complied with at the expiration of the time provided for herein, or any extension thereof, you are instructed to complete the same at the earliest possible date thereafter, unless we or either of us has made written demand upon you for the return of the money and/or instruments deposited by either of us, in which case you may withhold and stop all further proceedings in this escrow without liability upon your part for interest on funds held or for damages until written mutual cancellation instructions signed by all parties shall have been deposited in the escrow, whereupon this escrow will without further notice be considered terminated. 7. NO NOTICE, DEMAND OR CHANGE OF INSTRUCTIONS SHALL BE OF ANY EFFECT IN THIS ESCROW UNLESS GIVEN IN WRITING BY ALL PARTIES AFFECTED THEREBY. In the event conflicting demands or notices are made or served upon you or any controversy arises between the parties hereto, or with third persons, growing out of or relating to this escrow, you shall have the absolute right to withhold and stop all further proceedings in, and performance of, this escrow until your receive written notification satisfactory to you of the settlement of the controversy by agreement of the parties thereto, or by final judgement of a court of competent jurisdiction. All of the parties to this escrow hereby jointly and severally promise and agree to pay promptly on demand, as well as to indemnity you and to hold you harmless from and against all litigation and interpleader costs, damages, judgements, attorney's fees, expenses, obligations and liabilities of every kind which in good faith, you may incur or suffer in connection with or arising out of this escrow, whether said litigation, interpleader, obligations, liabilities or expenses arise during the performance of this escrow, or subsequent thereto, directly or indirectly. 8. You are hereby authorized to deposit any funds or documents handed you under these escrow instructions, or cause the same to be deposited, with any duly authorized sub -escrow agent, subject to your order at or prior to close of escrow, in the event such deposit shall be necessary or convenient for the consummation of this escrow. 9. All parties agree that as far as your rights.and liabilities are involved, this transaction is an escrow and not any other legal relation and you are an escrow holder only on the within expressed terms, and you shall have no responsibility of notifying me or any of the parties to this escrow of any sale, resale, loan, exchange, or other transaction involving any property herein described or of any profit realized by any person, firm or corporation (broker, agent and parties to this and/or any other escrow included) in connection therewith, regardless of the fact that such transaction(s) may be handled by you in the escrow or in another escrow. NO ACTION SHALL LIE AGAINST ESCROW HOLDER FOR ANY CLAIM, LOSS, LIABILITY OR ALLEGED CAUSE OF ACTION OF ANY KIND OR NATURE WHATSOEVER, HOWEVER CAUSED OR OCCURRED. UNDER THIS ESCROW OR IN CON- NECTION WITH THE HANDLING OR PROCESSING OF THIS ESCROW, UNLESS BROUGHT WITHIN TWELVE (12) MONTHS AFTER THE CLOSE OF ESCROW. 10. You are not to be concerned with the giving of any disclosures except as expressly required by Federal or State law to be given by an escrow agent. Neither are you to be concerned with the effect of zoning ordinances, land division regulations which may pertain to or affect the land improvements that are the subject of this escrow. 11. The parties to this escrow have satisfied themselves outside of escrow that the transaction covered by this escrow is not in violation of the Subdivision Map Act or any other law regulating land division, and you as escrow holder are relieved of all responsibility and/or liability in connection therewith, and are not to be concerned with the enforcement of said laws. 12. In the event any Offer to Purchase. Deposit Receipt or any other form of Purchase Agreement is deposited in this escrow, it is understood that such document shall be effective only as between the parties signing said document. You as escrow holder are not to be concerned with terms of such document and are relieved of all responsibility in connection therewith. You are to be concerned only with the directives specifically set forth in the escrow instruction and amendments thereto, and are not to be concerned or liable for items designated as "memoranda" in the within escrow instructions nor with any other agreement or contract between the parties. You are authorized to furnish copies of escrow instruc- tions, supplements, amendments, or notices of cancellation and closing statements in this escrow to real estate broker(s) and lender(s) referred to in this escrow. You are not required to submit any title report issued in connection with this escrow to any party or agent unless directed to do so by written mutual instructions. You may, however, do so without incurring liability to any party for such submission. You are hereby authorized to submit such report to any proposed lender. 13. Time is of the essence of these escrow instructions. In the event of failure to pay fees or expenses due you hereunder, on demand, I agree to pay a reasonable fee for any attorney's services which may be required to collect such fees or expenses. 14. if a party to this escrow unilaterally assigns or orders the proceeds of this escrow to be paid to other than the original parties to this escrow, such assignment or order shall be subordinated to the expenses of this escrow, liens of record on the subject property, and payments directed to be made by original parties together. If the result of such assignment or order would be to leave the escrow without sufficient funds to close, then you are directed to close nevertheless, and to pay such assignments or orders only out of the net proceeds due except for such assignments or orders, and to pay them in the order in which such assignments or orders are received by you. You are to furnish a copy of these instructions, amendments thereto, closing statements and or any other documents deposited in this escrow to the lender or lenders and/or the real estate broker or brokers involved in this transaction upon request of such lenders or brokers. In the event of an assignment or transfer or interest by operation of law, with or without the approval or consent of any or all of the parties hereto, you shall retain the right to deduct any and all escrow costs, fees and expenses provided for herein from said assigned or transferred funds, properties or rights, said assignment or transfer notwithstanding. 15. if there is no written activity by a principal delivered to this escrow within any six-month period after the time date as set forth in the escrow instruction or written extension thereof, your agency obligation shall terminate at your option and all documents, monies or other items held by you shall be returned to the respective parties entitled thereto less fees and charges herein provided. 16. If any check submitted to escrow is dishonored upon presentment for payment, you are authorized to notify all principals and/or their respective agents of such nonpayment. 17. These instructions may be executed in counterparts, each of which shall be deemed an original regardless of the date of its execution and delivery. All such counterparts together shall constitute one and the same document. 18. The parties to these escrow instructions authorize you to destroy these instructions and all other instructions and record in this escrow at any time after five (5) years from date of close of escrow. r - RECEIPT NO. /9'0 Issued By Date DISTRICT: ❑ Riverside, Ccs-lgdie- ❑ Hemet C7 Perris ❑ Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records 4 PAr COUNTY OF RIVERSIDE ENVIRONMENTAL Assn wrs Pumm No. HEALTH -SERVICES DIVISION 173 — 213 — Oct I - 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 speculations as indicated on the attached check IIsL A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this application -shall remain, valid for a period not to exceed one year from date of approval.' Q 7 VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # ,IW�oCAtYn.1�Y Z ' � . Agent Contractor, Contact Person Phone Address & Firm V SSS tA` \ ZIrL- 1"71 S. Tr1t^U O( �vvS Of Owner U.1 5 C Phone Mailing Address Ly z U rte/ city State Zip Job Property Address Legal Description Prop. (PM, Tract, Lot) LA ti— k —J -r."T LOT 72 WK 101 K N r T -7d- I I Lot Size i r ter Agent I Use of Permit P/P, CU, etc. � °V�ea�.� Other r 5-0 X 'toQ _ _� ailing M�S,►e � ,etc. t -2L "1 y Signature of Applicant Date CATEGORY: REV CODE FEE ` CATEGORY: REV CODE FEE B110SUBSURFACE DISPOSAL 1238 57.00 ❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00 co ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) Z LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00 O a 1 at 4 Parcels (Each) 1238 $ 57.00 (Less than 1 year) b. Each Parcel after 4 7344 $ 24.00 ❑ PRELIMINARY ELECTIVE 7352 $ 23.00 W ❑ .Rereview (2nd review same parcel) 7344 $ 24.00 EVALUATION (Attach DOH SAN 53) U)' ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $ 47.00 Critical Area 7348 $111.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $ 87.00 NI,TI/AL DATE - Holding Tank Agreements Completed ❑ YesNo-`'fi/� Certification of Existing S.D. System Required ❑ Yes No t WOCB Clearance required. (Attach Form ❑ Yes DOH SAN 007, Santa Ana Region Only) Sills Percolation Report Required. ❑ Yes e<No Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Plot Plans Required (1 to 5 fL interval) ❑ Yes N' Other ❑ Yes O� Staff Specialist Lot Inspection Required ❑ Yes l3 No Lot Inspection Date Sills boring report by Project # Date Sills Map Page _ Soil Type Approved by .e, Dabs �" • tel!) U QZ Z No. of Systems T of Systems) No. Dwelling Unite (i) (1) Septi: Tank Soft Rate /Sand O Holding Tank ❑ Existing Bedrooms, � G b L] New ❑ ReplacenwM h` . L%i%�1� Gal Gal ( Leach Line Sq. FL h Sidewall allowance Install Lines) ft long N wide wNh c Bed sq. k arae IL rock/ sq. R per running ft min. rpgk below drainl'nes or iLeach or bottom area Leachlines/bed special design for slope: (3) Pin Diameter No. Pits Pit Below (TD) Seepage ; ® th Applicable Inlet (BI) / { E? Max. Allow le Depth N/A t� Overburden factor No. 2 System A/4 REMARKS: 574,1-4,11-11 ." _ f / This application is , PP OVED `W&lE .for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompan n, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. No construction is permitted in the required reserved 100% expansion area. 0 Septic tank and sewer lines must be 50' minimum from any wellst�/ f `/ 15 IJJ () Leach lines must be 100' minimum from any wells, including expans area 0) Seepage pits must be 150' minimum from includi any wells, g expans n aaar (Q Signature of Health Officialrw�%`Grr[ f ?� r - RECEIPT NO. /9'0 Issued By Date DISTRICT: ❑ Riverside, Ccs-lgdie- ❑ Hemet C7 Perris ❑ Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records 4 PAr o ' of 14*+e OFFICE OF AGRICULTURAL COMMISSIONER AND •_04 WEIGHTS & MEASURES "'►� �!CALVIN C. KAMINSKAS JAMES O. WALLACE 14080 LEMON STREET, ROOM 19 Asststont Commissioner Agricultural Commissloner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE Director of weights.& Measures (714) 787-2561 Sealer 49613 Highway 86, Suite B12 Coachella, Ca. 92236 q (619) 342-8291 -> DATE. 3% 12 (U CASE NO. I C D A1 312-20 DEVELOPER'S NAME:. ADDRESS: 17 a n 4- • Cot �2osy TELEPHOM: (b tS) [�-f- `] f31 oCI<- 7-74e- u Y3Iacic Dear Developer: 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 from plant material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. AgriculturA1 on s Office cc: Indio and Riverside Office