003204 (SFD)Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
TO: City of La Quinta DATE:
Department of Community De velopment
78-105 Calle Estado
La Quinta, CA 92253
This is to certify tha�
developer of A&Ati�
located at 7 -'L7b
this District, has paid school facility
authority.generated b overnme t CZLS
$
covering a total of squ
-7
which is
within
fe�e-s imposed ��rsuant to the
( ) industrial/commercial development and
this footage in this development may now be
ioli)�53080 in tLhe am4 nt of
feet oe OLe 'residential or
that building permits for
issued by your jurisdiction.
f -or -DES9RT SANDS Uid I IED SCHOOL DISTRICT
White Building Department * Yellow Facilities Planning 0 Pink - Accounting 0 Gold - Developer
#-' --; 9 � �-'/ 1 7 C f --c =il- 3;1-� a J 0 (10)-37
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COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
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 $37 is required when the application is submitted. Check must be made payable to the County of Riverside -
Building Department Application Log:#
Name (Owner,. Agent, Contractor, Etc.)
Mailing Address
sr
City
State
Zip Code
Telephone
'Job Properly Address
'City or.Community,
'LegalDescription of Property. (Lot,PM, TR)
�.�iof; j r'�' r
_ r �� '.���4.r:
�: ti.''�fftfl YfA7� �•
'Assessor's Parcel No
Water Agency or.Well.-
7� _ -
Perini? Planning Case
Lot Size
Use of §
r�
SFD, MH Site Preparation Etc:�X
Signature of Applicant Date
'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 ❑ No
WQCB Clearance required. ❑ Yes ❑ No
_
Soils feasibility report required. ❑ Yes ❑ No
Detailed boring report required, ❑ Yes ❑JNo
Detailed contour plot plans required. ❑ Yes ❑�No-
Staff Specialist approval required. ❑ Yes ?I No Lot Inspection Date
Soils/boring report by Project # Date
Soils Map Page -_. Soil Type Approved by Date
Type of System:
No. of Bedrooms (1) Septic Tank
Soil Rate Required
❑ Existing ❑4'New ❑ Additional ❑ Replacement
,i Gals.
r
(2) beach line sq. ft.
Sidewall allowance
Install Line(s) Ft. Long,
Leach bed Sq
(Bottoomyrtrench area)
ft, rock/—Sq. Ft.
—Ft. W d"e-wit min. inches
Ft. of bottom
per running ft. Z.N/A
rock below drain lines
area
Leach lines/bed-special design for slope:
(3) Pit Diameter
No. Pits
Pit 10
Seepage Pit total depth
Applicable
N/A�Overburden factor
.- . '
� 5� �}
• Max. allowable depth
This application is approved/denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements
set forth in Section B 3b"ove. A building permit is necessary for the installation of the above -designed system.
r
(1) Septic tank and sewer lines must be'50' from any wells . . . V ..
(2) Leach lines must be 100' min. from any wells including expansion area
(3) Seepage pits must be 150' min- from any wells including expansion area
Signature of Health Official + Date
RECEIPT NO- I ' 1 {'
a
Issued
Date " I I
District: ❑ Riverside Ed -,Indio
Distribution: WHITE —Office file
DOH-SAN-122 (Rev. 6/86)
❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
YELLOW —Applicant PINK —Bldg. Dept, GOLDENROD —Pending File