1989 RES R-90-89 - Laserfiche WebLink

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(t)' car lir NN .1,, Surf lie, i,r.rn. Al. D:cnic,Pal Cnriv'.Lhn nr CMI Subdiriuon) S TATE OF CALIFORNIA DEPARTMENT OF HEALTH Application from ......... of Colton_ (Name of municipality or civil subdivision) organized under ._....... the general laws of the State of California, incorporated _july 11,-1887 (State v bother special charter or ander aeoeral law, aiviag elan and data of incorporation) lu r State Department of Health 2151 Berkeley \Vay Berkeley, California 94704 Pursuant and subject to all of the terms, conditions and provisions of Division 5, Part 1, Chapter 7, Sections 4010 to 4035 of the California Health and Safety Code and all amendments thereto, relating to domestic water supplies, application is hereby made to said State Department of Health for a permit to Amend existing Water Supply Permit No.drilling.............. -65-117 to include the - Applicant must state epeei5ca11.• w,bat it being applied for —wh'sther to construct new works, m usa existing works, to make alterations or addition is ,•_3nf}--gpgron_of_a new_cott¢nunity-water supply_—well_locted n@ar_Fairwav_Drive -__- e,orkr m ,eurees and state usture of imrrovement in works. Eoumerste definite]- source or sources of supply-, kind of works used or conddered (if known) and Cross Roads Drive in the City of Colton (see attached drawing). - - - - -------------- -------- cod specify eba loea]iy to be sensd. Additional sbeetr may bs attaebed. Dated ....... —?/1f ------- --------- ---------- 19V- AFFIX Orm%L r,i I� HERE Attest. -� a- .......... ............ (Signature of clerk or corresponding o5cial 'ith tide and port cisco address) of.-CQltp�a_Municipal-_Corporation (Name of municipality or civil subdivision, in full) ---- -------------- (slgnm,& elite es < officer w,tb offieW b an n n address) 1\OM Before making application for permit, such action must be authorized by resolution of the governing board, substantially in the form furnished by the State Department of Health (Domestic Rrater Supplies, Form A2) and a copy of such resolution, duly certified by the clerk of such board, must accompany the application. aH 100 110.1&) cwu.sa, u.n am (D eau