003782 (SFD)Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado
LA
L-A
La Quinta, CA 92253 NOVICE: THIS DOCUMENT CANNOT
BE DUPLICATED.
This is to certi.fy ' that
developer of which is
,- -g
located at within
this Districrt, has paid school facility fees imposed pursuant to the
authority anerated by Government Code Section 53080 in the amount of
$
covering a total of -square feet of residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
for DESERT SANDS-UNIPIED SCH06L DISTRICT
White - Building Department 0 Yellow - Facilities Planning 0 Pink - Accounting 0 Gold - Developer
ev<� 9J -37,Y 0007
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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 $40 is required when the application is submitted. Check must be made payable to the County of Riverside.
Building Department Application Log #
Name (Owner. Agent. Conuaclor. Etc) Mailing Address
V
Glt
Slate _ ; `
Zip Code
Telephone
'Job Property Address
'GI or Community
'Legal Description of Properly (Lot PM TR)
r : ,
�7 �� , ---,
% ! i r�, it % •- U
'Assessors Parcel No
Wale, Agency dr Well
Lot Size
11
SZ — V Q l
b1- —0{
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Use of Permit Planning Case M
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, f
SFD MH Site Preparation Etc
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_
Signatute.of Appticant Dale -
'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' f
Special feasibility boring report required. ❑ Yes D No
Detailed contour plot plans required. ❑ Yes ❑ No
Staff Specialist approval required. ❑ Yes ❑ No Lot Inspection Date_
Soils/boring report bProject 1i Date
Soils Map Page Soil Type —Approved by Date
Type of System:
No. of Bedrooms
(1) Septic Tank Soil Rate Required
❑ Existing ❑ New ❑ Additional ❑ Replacement
Gals.
(2) Leach line sq. ft.
Sidewall allowance
Install Line(s) FL Long,
Leach bed Sq
(Bottom trench� area)
—ft. rock/ Sq. Ft
Ft Zab%witb min_ inches
Ft of bottom
per running ft_ 0-N/A
rock below drain lines '~i
area
Leach lines/bed-special design for slope:
(3) Pit Diameter
No Pits
Pit BI
Seepage Pit total depth
Applicable
N/A ir�Overburden factor
,5 ❑ 5,
—F
Max. allowable depth
- _ 1 f �a
v
This application is apaoyed/ciecied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements
set forth in Section B above. A building permit is necessary for the installation of the above -designed system-
(1) Septic tank and sewer lines must be 50' from any wells !-
(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
Y
Signature of Ffeafth Otfioal Dale
RECEIPT NO._ Issued by
District: ❑ Riverside ❑ Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE —Office file YELLOW —Applicant PINK —Bldg, Dept. GOLDENROD —Pending File
DOH SAN 122 (Rev 8/87)