HomeMy WebLinkAboutCC Reso No 1981-15STATE OF CALIFORNIA
DEPARTMENT OF HEALTH .
- RESOLUTION N0. 8T-15 ~ -
Applicationfrom.._City of Lake_ETsinore Water Department -
------------------------=-----
. (Name of mvatc{yallq or dva subdtvlafon) __. . _
organized under_Incorporation date - 1888
- ~ (State whetter special charter or under genozal Lw, gtvinq clan r,nd date of tncorporatlozr)
To the State Department of Health
2151 Berkeley Way -
Berkeley, California 94704
Pursuant and subject to all of the terms, rnnditions 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 domes+ic water
supplies, application is hereby made to said State Department of Health for a permit to_replace_55_,-1 ~0______
1 i nea 1 __feet__gf__2"- wat~r__pi pe__~(i_irh_ ~ "__~gj~QStag_cement._~1R~>_and__r_e~_l;it:Q__1}5yD_1inf:al______
Ayplicant mwt mute sp•ci6cally what lr being applied for-wtetter to conatnrct new worm, to we ezfstlag works, to make allerotlom or adzlitlou is
feet of 6" steel pipe with 12" asbestos cement pipe. Water supply is currently pur-
wohs or aouzcer end stab nature. of impn>vemavt in works. Eoumente defsitdy source or aourros of supply, kind of works used or rnwidered (lf kmwa)
chased.-from _Elsinore_Valley__Muni ci_pal__Water- Di stri ct,:___Thi s__project -wi 11-_serye_the ___
and spedfy tte ]ocaliry to be served. Additional aheW meY be attarlred.
entire_Lake_Elsinore_W~ber__Sy_Stem.__Y1hiC.h_i_5 _lA.cii_tell__f1n_:th~eastf:r_n__p(zr_ti on._of__ihQ_____.__
City.. -
Dated..-.:....aril 14--°----------[ 19.81 t
A~ ~ _ City of Lake Elsinore
OFFICTl.I. SEAL (Name of mmicfpallry or dW rubdivLiov, Ia full)
H1atE
By 22~ _ ~--- --~~- -
- --- -------- ----- -----------
Attu+St, (afgnaNn of cite[ ezecutlve o set with
o1lrt.t title mdpost office addreu)
y~~~ `z2--~~ y~ ~ Jer!ll~~~r H. Stewart Ma or
-------- --~ -----------'- ----X-----------------
(Sigrvture of clerk oz eonespovdivg cffidal
wilt title and post office addrev)
Florene Marshall_~-_City~Clerk .____ CitY_Hall~__13Q Ss_~Iai_~,~tx-~~~_______-_
Lake Elsinore, CA 92330 -
Ntn-fs .
Before malting application for permit, such action must be authorized by resolution of tba governing board, substantially in the
form famished by the State Departrneot of Health (Domestic Water Supplies, Form A2) end a copy of such resolution, duly
certified by the clerk of such board, must acrnmpany the application.
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Applicationfrom._City of Lake_Elsinore Water Department
(Name of mnnfdpallq or dv- rulsdtvlafon)
organized under._Incorporation date - 1888
- --- ----------------------
(State whether apedal eLarter m vndm genenl law, Rlviny clan and dale of incorponyoa)
To the State Department of Health
2151. Berkeley Way -
Bt:rkeley, 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 domesic water
supplies, application isherehy made to said State Deparment of Health for a permit to_replace_55-,1-~0--____
lineal __feet_of _2" _ watQr__pi pe__wj_iih_ 6_'"__;jSkeStns._cement__DiRe>_and__rep_lacQ__1. SyA.1_ineal_____..
Applicant must state speci6ca)lY what is being applied for-whether to contCVCt aem work; to we arLtiny world, to sake Jinn COw or ndditlom In
feet of 5" steel pipe with 12" asbestos cement pipe. Water supply is currently pur-
works or sourm and stato. nature of f:nPVVCment in works. £numente de..m[ely source pz wurces of wpD1Y. kind of works used or eonside. ed (if kmua)
chased from_E_lsinore VaTley_Munici_pal__Water_District,____This__project_.}_rill__sery_e_the______.
and rrreclfy the I«ality to be served. Additional sheetr mnY be a[tadvd.
entire_Lake_E_isinQre W'r~ter__~y_ate[a,__t~hich_i_s__1QnatQd_an__the_eastQr_n__por_~iol~_9~_.the________
City.
Dated - ----A_pril_ 14 ---------------+ 19 81
"~11-F•rx
CIFFICIAT. SEAL
,.. HFAF Jp'
Attc~t.
~ .; .
y
~ y ~ ~
~.~"--~.e/ILI~-L_ _-far/--fry- -c~4~_--__---_.
(SiRusture o[ clerk or corresponding eSidal
with title and post of&ee address)
City of Lake Elsinore
(Name of maaicipallty os d~vil subdtvlsion, to full)
BY - - -- - ~ ~~ll~~~L~~_.._-- --- ------ --- -------
~(SiaaaNre ofsSfe( ezecutiv officer with
oEdal title and port ofSce addmu)
Jerry-H..__Stewart, _Mayor ___________
Florene Marshall-~_Cit~Clerk ,____ Cit~r_Hall~_:13Q S,__Ma~IL,~t-r-eet`_-:______
Lake Elsinore, CA 92330
NorFS .
Before making ayplication for permit, such action must be authorized by resolution of the governing board, substantially in the
form furnished by the State Dzpartrnent of Health (Domestic Water Supplies, Form A2) end a copy of such resolution, duly
cerii&ed by the clerk of such board, mtsst accompany the application.
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