003839 (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 Quinta, CA 92253 K5,07 ICE: ViiiS 11.iOCUMENT CANNOT
BE DUPLICATED.
—.2
QIN
This is to certif�y h F
d e v e 1 o p e r o f which is
located at fAZA6:--=� within
this District, has paid school facility fees imposed pursuant to the
authoritv,genera b G vernment Code Section 5308,0 inpsamount of
$
id ial
covering a total ol square feet of (-Z 1 --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-UNIFIE\D-SCHOOL DISTRICT
White - Building Department 0 Yellow - Facilities Planning 0 Pink - Accounting 0 Gold - Developer
17.44, (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 $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 Contractor- Etc) Mailing Address
City
Stale
Zip Code
Telephone
'Job Property Address
'City or. Community ' Legal Description of Property (Lot PM TR)
'Assessor s Parcel No
Waler Agency 6r wUl
Lot Size
`
Use of Parml Planning Case M
e
SFD. MH Site Preparation Etc
S,grlattlre of Applicant 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 El No _
WOCB Clearance required. ❑ Yes D No _
Soils feasibility report required. ❑ Yes ❑ No
_
Special feasibility boring report required. ❑ Yes d No
Detailed contour plot plans required_ ❑ Yes Q No
Staff Specialist approval required. ❑ Yes C No Lot Inspection Date _
Soils/boring report by d' " Project # Date
Soils Map Page_ Soil Type Approved 6y Date- . -
Type of System:
No. of Bedrooms
(1) Septic Tank
Soil Rate Required
❑ Existing ❑rNew ❑ Additional El Replacement
�7"�_ N-%. x
` Gals
} ` �
(2) Leach line sq. ft.
Sidewall allowance
Install Line(s)Ft Long,
Leach bed Sq
(Bottom trench area)
ft. rock/ ,.Sq. Ft.
Ft. wide with min. inches
Ft, of bottom
el
per running ft. ❑ N/A'
rock below drain lines
area_
Leach lines/bed-special design for slope:
(3) it Diameter
No. Pits
Pit BI
Seepage Pit total depth J
Applicable
❑ 5' Q 6'
Max allowable depth
N/A _ Overburden factor
L of ,.. 'R� a "� -k
e n 7 C U sr C] c., C f
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 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
Signature of Health Official Datp
Issued
Date. .
RECEIPT NO._ —
District: ❑ Riverside El Indio
Distribution: WHITE —Office file
DOH SAN 122 (Rev 8/87)
❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
YELLOW —Applicant PINK —Bldg. Dept. GOLDENROD —Pending File