Loading...
003890 (SFD)-TA* i if 4 uGl'�trGv P.O. BOX 1504 No, 00389 Building 78-105 CALLE ESTADO Address 80-140 VIESTA GRANDBI, LA QUINTA, CALIFORNIA 92253 Owner g yp��ay•�t��pp��g� ��� " F,rs:�VZ'13a� •sr 'JL' ems+ Mailing " Address 79-811 COMTRY Cha City Zip Tel. EMMA D=S' 345-6225 Contractor DON ARD Address 733 COMMY CLUB BUILDING: TYPE CONST. OCC: GRP.• A.P. Number, 617-181-007 Legal Description x t Project Descriptions. 'City._ Zip Tela BENOW DUNES 345-6225 State Lic. ' & Classif. 47600, City o Lic. # 4 SQ e t'. ^ ' ;����..... No. No. Dw. Stories Units A ... Arch., Engr:, Designer g�y J� ' New ❑ Add ❑ Alter ❑ Repair ❑• Demolition ❑ Address Tel. r Satin City Zip 0 .. State _ 'L'ic. #7. LICENSED CONTRACTOR'S DECLARATION . L 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 fulLforce and' effect. . SIGNATURE DATE OWNEWBUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's. License Law for the following reason: reason: (Sec. 7031.5,Business ,and Professions Code: Any *city or county :which requires -a - 'peimih: fo construct, alter, improve, demolish, or repatr any 'structure, ip'non to its . issuance also requires athe 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 they Business and Professions Code, or. that: he is exempt therefrom, and-the'basis- for the alleged exemption. Any violation of Section 703 1.5 , 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, Contracto_r's License Law does not apply to an owner of properly who Estimated Valuation '96'.. -PERMIT - - AMOUNT Plan.Chk. •Dep. ' . • Plan ChkBal ii 96 a 7.i - Const.. . p - ~ sxj + a .Mech. - - ` l?n010 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.). .. EI@CtrlCal Plumbingi.,i�J O I, as owner of.lhe 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 Contractors License Law.) . 0 I am.exempl under. Sec. - B. & PIC. for this reason _ S•M•I, Grading 2!�i_t3 Driveway Enc. - ! 20.o0 Dateowner Infrastructure .. �„ 174.31 FriwAta-Yews UmTd 150.61) 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. . . TOTAL fix, REMARKS _ CERTIFICATE OF EXEMPTION FROM t WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation orless.),. .. .. .. .... -. ... ._ .I certify that in the performance of tha work for which this permit,is issued, Ishall not employ any person in any manner so as to become subject to the Workers' Compensation ' Laws of California. 1-tt.,grbL`++..+J J: <i !•y+r-�.f�.�-c i, .a ,� �,, „x�r; �, •a"47:=A 4 'i;s ST"s i,� - c •- - w • - - -- - - - 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. t ZONE: - � BY•r- _ .. MIf11 fT1Um Setback Distances: ' Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY _ Side Street Setback from.Center Line 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.). - - Side Setback from Property Line Lender's Name Lender's Address FINAL DATE by: Validated by: INSPECTOR ' Date' 's��`,�i.�M Permit 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.ISSUed 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 Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. ® POR. SO. FT. ® GAR. SO, FT, ® CARP. SO. FT. WALL SO. Ff. ® 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 FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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 BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 C SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® 3/ac HOUSE SEWER FINAL INSP. :�VROOFING 1q, 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 PLUMBIN . 4UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE S ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SEPTIC ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) .METER LOOP HEATING (FINAL) OTHER APP./EOUIP. 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. :�VROOFING 1q, V 0 cv / /�/xL�� - J/ 3 � A�� . GAS j REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL / c THING -7C EL `!�'O MESH t CSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS, GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT' OF . 3;,:i SCHOOL FACILITY'FEES NOTICE: THI&D6CUMENT CANNOT TO: City o a-QVjPnWCATE®. DATE: /eO ^ `DeparItment of Community Development 78=105 Calle Estado` ' La Quinta, CA' 92253 , f This 'is' to certify that 112 developer of wh'c is' located 'at /% / f in', this District, has paid school facility fees impos d pur want to t e aut ori generate by Gove lament Code Se tion 3080 in the mount of All - covering a total oft/6fl square• feet of .( ) r. si ential or ( ) industrial/commercial development and that buil ing permits for this footage in -this development may now be issued by your 'jurisdiction. f r ESERT SANDS..( IED SCHOOL, DISTRICT White - Building Department .• Yellow - Facilities Planning Pink - Accounting • Gold - -Developer ' .(10)-37 j• FIDELITY NATIONAL TITLE INS. CO. . " Order No:, Esi'"ow' No. 1180-4 Loan, N/). WHEN RECORDED MAIL TO: Doti Howard & Emma Howard ;,-79-811 Country Club Dr, "B" 1' Bermuda Dunes, Calif 92201 NO COR Mr 1 . MAIL TAX STATEMENTS TO: DOCUMENTARY TRANSFER TAX 125.40 ... Computed on the consideration or value of property conveyed;0R same as above ...... Computed on the consideratiomorrvalue less lien: anc, nt.rances 1 remaining at time of sale. "-the-.undersigned-- Signature of Declarant or Agent determining tax — Firm Nam, G,RAN.T DEED } FOR AL VALUABLE CONSIDERATION, receipt of which is hereby. acknowledged, EDUARDO U. TIOSECO, EMMANUEL TIOSECO, MARIA ELVIRA OCAMPO; ELVELYN T. GALANG AND EDGARDO ��L�.TIOSECO, AND EXUPERIO L. TIOSECO AND EDUARDO U.-TIOSECO, AS TRUSTEES OF.THE TIOSECO FAMILY TRUST DATED AUGUST 26, 1982 hereby GRANT(S) to , DON HOWARD AND EMMA HOWARD, husband and wife as joint tenants ,the real property in the City of County of Riverside State of California, described as personally known to me (or proved to me on the.basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same. WITNESS my hand and official seal (This area. for official notarial seal) `Signature 1002 (6/82) MAIL TAX STATEMENTS AS r-% ABOVE 97t 471, 4 A4"t co W tl CD E C73 4' U LA;oc � . p N IL 17 J 8 ca > O 0 ; W W iY t r 1 SPACE ABOVE THIS LINE FOR, RECORDER'SL USE MAIL TAX STATEMENTS TO: DOCUMENTARY TRANSFER TAX 125.40 ... Computed on the consideration or value of property conveyed;0R same as above ...... Computed on the consideratiomorrvalue less lien: anc, nt.rances 1 remaining at time of sale. "-the-.undersigned-- Signature of Declarant or Agent determining tax — Firm Nam, G,RAN.T DEED } FOR AL VALUABLE CONSIDERATION, receipt of which is hereby. acknowledged, EDUARDO U. TIOSECO, EMMANUEL TIOSECO, MARIA ELVIRA OCAMPO; ELVELYN T. GALANG AND EDGARDO ��L�.TIOSECO, AND EXUPERIO L. TIOSECO AND EDUARDO U.-TIOSECO, AS TRUSTEES OF.THE TIOSECO FAMILY TRUST DATED AUGUST 26, 1982 hereby GRANT(S) to , DON HOWARD AND EMMA HOWARD, husband and wife as joint tenants ,the real property in the City of County of Riverside State of California, described as personally known to me (or proved to me on the.basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same. WITNESS my hand and official seal (This area. for official notarial seal) `Signature 1002 (6/82) MAIL TAX STATEMENTS AS r-% ABOVE 97t 471, 4 A4"t STATE OF CALIFORNIA COUNTY OF RIVERSIDE SS On this the 9thday of October 19— 11 BAFElap me, the undersigned Notary Public; in and for said County $ d State ri FOR NOTARY SEAL OR STAMP N w personally appeared � � ,� EVELYN GALANG Cr Proved to me on the basis of'satisfactory evidence to be the pe whose name(s) is rsons) subscribed to the within, OFFtCIAI SEAT instrument, and acknowledged that she executed the same. ao 1 Judy Sagerstrom ; c ="NOTARY PUr'UC•CAUFORNIAi Y Q PRINCIPAL OFFICE I RIVERSIDE COUt7j"9 a y S RST � MY Commission Expires July 9.1 c� y e�3 U. STATE OF CALIFORNIA COUNTY OF RIVERSIDE _ S.S. On this the 9th day of Oct 19 _87_n.belore me,' of the undersigned, a Notary Public in and for said County and State, personally appeared_,r...___EVELYN_.__._,r__GALPVG i proved to me on the basis of satisfactory evidence to be the person(s)—whose name is QI subscribed to the within instrument, as the Attorney—in fact of E EDGARDO L. TIOSECO Q O and acknowledged to me that SHE subscribed the name EDGARDO L. TIOSECO CO) of � thereto as Go • principal and her own name—as Attorney—in fact. a d n Signature [r% m a JUDY SEGEASTROM U , STATE OF CALIFORNIA } S.S. COUNTY OF RIVERSIDE I d9th Oct 87 before me, da a On this the y of 19 (A the undersigned, a Notary Public in and for said County and State, personally appeared EVELYN GALANG proved to me on the basis of satisfactory evidence LL to be the person(s)—whose name i5 c i subscribed to the within instrument, as the Attorney—in ' fact of EXUPERIO L. TIOSECO 0 Q and acknowledged to me that She subscribed the name of EXUPERIO L. TIOSECO thereto as. N c principal and her own name—as Attorney—in fact. a Signature n #Na:RSTROM �o L) FOR NOTARY SEAL' OR STAMP OFFICIAL SEAL ; Judy Segerstrom 4 NOTARY P0IIC CALIFORNIA PRINCIVAI t1i I iCE IN RIVERSIUC COUNTY My Commission Expires July 7, 1991 FOR NOTARY SEAL OR STAMP OFFICIAL SEAL "-r• .f t,Iciy Segerstrom _NO'iA0 PU81I . ICE IN PRINCiFi+ ".• LO JNT RIVERSIOt 1991 My Commission Expires JuIY 7• H� EUU ECO STATE OF CALIFORNIA } S.S. 9 COUNTY OF RIVERSIDE d On this the 9th day of OCt 198_before me, N the undersigned, a Notary Public in and for said County and State, personally appeared EVELYN GALANG proved to me on the basis of satisfactory evidence LL to be the person(s)—whose name is subscribed to the within instrument, as the Attorney—in fact of E MARIA ELVIRA OCAMPO ' , 0 � and acknowledged to me that She subscribed the name M of MARIA ELVIRA OCAMPO thereto as co principal—and—her own name—as Attorney—in fact. - -�9�nr °C Signature�LTDY SEGS T C.) i U STATE OF CALIFORNIA } S.S. d COUNTY OF RIVERSIDE1 . 1 87 a. On this the 9thday of Oct 19 before me, Nthe undersigned, a Notary Public and for vsaid County and State, personally appeared proved to me on the basis of satisfactory evidence to be the persons)—whose name 1S i T) DO subscribed to the within instrument, as the Attorney—in fact of E EDUARU. TIOSECO Q and acknowledgged to me that SHEsubscribed the name of EDUARDO U • TIOSECO thereto as - principal and HER own name—as Attomey—in fact. i iCc i rl n N C? U Signature JU6Y SEGERSTROM the same. SAFECCOO FOR NOTARY SEAL OR STAMP OFFICIAL SEAL Judy Segerstrom NOTARY PUBLIC•CALIFORNIAy PRINCIPAL OFFICE IN o RIVERSIDE COUNTY 0 ° My Commission Expires July 7. 1991 ° FOR NOTARY SEAL OR STAMP ,�•0, OFFICIAL SEAL Judy Segerstrom NOTARY PUBLIC -CALIFORNIA PRINCIPAL OFFICE IN RIVERSIDE COUNTY My Commission Expires July 1, 1991 ♦ •+-rte FOR NOTARY SEAL OR STAMP OFFICIAL SEAL neo Judy L#_*.Segerstrom 2 m? o NOTARY PUBLIC - CALIFORNIA PRINCIPAL OFFICE IN • .y RIVERSIDE COUNTY ��M�y Commission Expires July 7, 1991 _ , _ ...�-A'_ •v..T�A H,,.�r'7.` i ..��.;tirt.� kY rn r �'�fCxu—�.y„"°�.=�`=•� 1-_-..,._.._ _...n..W.__ .�.�__.._. ._ S.S. On tfn� Ute.. 91 -.—.day of OCt 19 $7 before me, the undersigned, a Notary Public in and for said County and State, EVELYN T ,AT,M". personally appeared aproved to me on the basis of satisfactory evidence u' O to be the person(s)—whose name is c subscribed to the within instrument, as the Attorney in fact of E ENINIANUEL TIOSECO Q and acknowledged to me that She subscribed the name of EMMANUEL TIOSECO _thereto as, CM CD principal—and heY own name—as Attomey—in fact. i SignatureCn Y SE ERS TRCA c� STATE OF CALIFORNIA } S.S. 9 COUNTY OF RIVERSIDE d On this the 9th day of OCt 198_before me, N the undersigned, a Notary Public in and for said County and State, personally appeared EVELYN GALANG proved to me on the basis of satisfactory evidence LL to be the person(s)—whose name is subscribed to the within instrument, as the Attorney—in fact of E MARIA ELVIRA OCAMPO ' , 0 � and acknowledged to me that She subscribed the name M of MARIA ELVIRA OCAMPO thereto as co principal—and—her own name—as Attorney—in fact. - -�9�nr °C Signature�LTDY SEGS T C.) i U STATE OF CALIFORNIA } S.S. d COUNTY OF RIVERSIDE1 . 1 87 a. On this the 9thday of Oct 19 before me, Nthe undersigned, a Notary Public and for vsaid County and State, personally appeared proved to me on the basis of satisfactory evidence to be the persons)—whose name 1S i T) DO subscribed to the within instrument, as the Attorney—in fact of E EDUARU. TIOSECO Q and acknowledgged to me that SHEsubscribed the name of EDUARDO U • TIOSECO thereto as - principal and HER own name—as Attomey—in fact. i iCc i rl n N C? U Signature JU6Y SEGERSTROM the same. SAFECCOO FOR NOTARY SEAL OR STAMP OFFICIAL SEAL Judy Segerstrom NOTARY PUBLIC•CALIFORNIAy PRINCIPAL OFFICE IN o RIVERSIDE COUNTY 0 ° My Commission Expires July 7. 1991 ° FOR NOTARY SEAL OR STAMP ,�•0, OFFICIAL SEAL Judy Segerstrom NOTARY PUBLIC -CALIFORNIA PRINCIPAL OFFICE IN RIVERSIDE COUNTY My Commission Expires July 1, 1991 ♦ •+-rte FOR NOTARY SEAL OR STAMP OFFICIAL SEAL neo Judy L#_*.Segerstrom 2 m? o NOTARY PUBLIC - CALIFORNIA PRINCIPAL OFFICE IN • .y RIVERSIDE COUNTY ��M�y Commission Expires July 7, 1991 _ , _ ...�-A'_ •v..T�A H,,.�r'7.` i ..��.;tirt.� kY rn r �'�fCxu—�.y„"°�.=�`=•� 1-_-..,._.._ _...n..W.__ .�.�__.._. ._ PARCEL 6: Lot 14 of Tract No. 3,505 in the County -of Riverside, State of:California,,as per Map recorded .in Book 57, Pages 7 and 8.of Maps, in the Office of the County Recorder of said County PARCEL 7:, Lot 15 of Tract No. 3505 in the County of Riverside, State of California, as per'Map recirded in Book 57, Pages 7 and 8 of Maps, in the Office of the County Recorder of said County. O LEGAL DESCRIPTION PARCEL 1: Lot 6 of Tract No. 3505 in the Cuunty of Riverside. State of C.Alifornia.'as " recorded in Book 57, Pages 7 and 8 of maps. in the:Ofice of ser the County RKeuccS�e P u(said County PARCEL 2: Lot 7 of Tract No. 3505 in the County of Riverside, State of .• .. , `•w '. •' California, as tY i,_ IC -� ,i. A.H.. ' Map recorded in Book 57, Pages 7 and 8 of Maps, in t -he Office of per the County Recorder of said .County ; PARCEL 3: Lot 8_ of Tract No. 3505 in the County of Riverside, State of California, as per Kap recorded in Buok 57, Pages 7 and 8 of claps, in the Office of the County Recorder of said County PARCEL 4: Lot 12 of•Tract No. 3505 in recorded the County of, Riverside, State of California, as per -Map in Book. 57, Pages 7 and 8 of Maps, in the Office of the County.Recorder of said County PARCEL 5: Lot 13 of Tract No. 3505 in the County of Riverside, State of California, as per Map .recorded in Book 57, Pages 7 and 8 of Maps, in the Office of"the. County Recorder of .said County PARCEL 6: Lot 14 of Tract No. 3,505 in the County -of Riverside, State of:California,,as per Map recorded .in Book 57, Pages 7 and 8.of Maps, in the Office of the County Recorder of said County PARCEL 7:, Lot 15 of Tract No. 3505 in the County of Riverside, State of California, as per'Map recirded in Book 57, Pages 7 and 8 of Maps, in the Office of the County Recorder of said County. nI Te Z O H U W U) Y Q. 2 W U w U) COUNTY OF RIVERSIDE, ENVIRONMENTAL'HEALTH SERVICES DIVISION _ PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM Applicant: Submit this form with four copies of r. scared plot plan (1- 0 sca rawn to County specifications required on the attached check list. A non-refundable filing fee of $40 is required en the application is submitted. Check must be made payable to the County of Riverside. Building Department Application Log # "Name (owner gent. Contracttoor. Etc/) MaArng.Address State Zip Code Telephone �>zr 'Job Property Address "Cd�.o•Com/.,mmunitym-- 7 Legal Description of Property. (Lot. PM. TR) - 'ASSe550r'S Parcel No 3 enc•"t'�VHI• V� ��J/�.y,�i use of Permit X64. dl4/ ;'�+ - Planning Case # Lot Size — f --• j / 4C.....��SS��" SFD. MH Site Preparation Etc. r A Signature of AppLcant Date. ' -Th 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 ©L�J6/ T{ Soils feasibility report required. ❑ Yes N; l Special feasibility boring report required. ❑ Yes�o tZ Detailed contour plot plans required. ❑ Yes L' l�No I Staff Specialist approval required. ❑ Yes D No Lot Inspection Date Soils/boring report by Project # Date Soils Map Page//j60'//_7 Soil Type�Approved by /+� Date Type of System: V� No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing LNew ❑Additional ❑ Replacefrent r. r'� .. Gals. (2) Leach line sq. ft. Sidewall allowance n •� V°r I Install +� Liner 467 ,Ftt..Long, Leach bed Sq. (Bottom trench area) ft. rock/ Sq. Ft. _ Ft. wide with min. AP- s Ft of, -bo om :. UQ per running ft. ❑ N/A rock below drain lines area Leach lines/bed- ecial design for slope: Applicable❑�I�I (3) Pit Diameter F , No. Pits Pit BI �` Seepage Pit total depth Max. al o1`vv able depth N/A 4^'' Overburden factor '�•� 'G�s' LO �A'a�-e�J,•.�;^:L.•-.LfGlh�•/�/lrf+iX r r/'ls,h�3 r 44� 17 This applicatio isapf� pp drdenied o the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements installations of the above -designed system set, forth in Section B above. A building permit is necessary for the d, 1 OL Septic tank'and sewer lines must be 50' from any wells(>'�U��^ Leach lines must be 100' min. from any wells including expansl0 area ((( (3), Seepage pits 150' min. from any wells includi�nyg expansionarea /must �be c Signature Of Health Onial f' 1Daf0- RECEIPT NO.Issued by��` Date- ,. District: ❑ Riverside ❑] Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE -Office file YELLOW -'Applicant PINK -Bldg. Dept. GOLDENROD -Pending File OOH SAN 122 (Rev 8/87) I 92