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FOR OFFICE USE: <br /> Date Issued !"K <br /> ------------------- This Permit Expires "I Year From Date Issued <br /> Application is hereby made to'the San Joaquin Local Health District for a permit fo.consfrucf and ins-01 the work herdin described. <br /> This application is madip in compliance with County-Ordina-nce No. 549. M 1-C-119 <br /> oOJOB ADDRESS AND <br /> Installation will serve: Residence J�J�Apartment House 0 Commercial E] Trailer Court [] Motel 0 Other L] <br /> Number of living units: _1--- Number of beclrooms,�mber of baths 2n- Lot size ------ --------- - <br /> Private [E"�Dpth to Water Table _X it. <br /> Water Supply: Public system El Community system El <br /> Character of soil to a depth of 3 feet: Sand Z--Gravel F] Sand� Loa�'E] Clay Loam I E] .Clay E]" Adobe,E] Hardpan 0 <br /> ,PreY110US Application Made: (if yes,date ........ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br />� -__�N -permitted if public sewer is available within ZQkfpet.) <br /> o-septic tank or cesspool <br /> Se f' T nk: Distance from nearest well---5V------Dist'ance from foundaf ion---�O---------Ma;fTer)-al ---------- <br /> Dispbsal Field: Distance from nearest well----5_0-----Distance from foundation---IV--------Distance to nearest lot line ---------- <br /> Type of filfe' r material-- of filter material-----/- --- ------ <br /> I hereby ce�r if hat I hav� pre�ared this 6pplication and that the�`work wifi be done in accordance with San Joaq in County <br /> aw <br /> ordinan tre �.ws, and�rules n gul fions of the San Joaquin L�cal Health District. <br /> (Plot plan, showing size of lo+, locaii�_n o�rysiern'in_rela�ion'f� wells, buildings, etc., can be n Wreyer�seek W). <br /> FOR DEPARTMENT USE ONLY <br /> BUILDING PERMIT ISSUED <br /> . .. <br /> A�*ra+�nsand/or necnmmon6at�no _----- -------------__------_—.---__--'_._----_---_--- - <br /> .________________..--__________ - --------------------------------------------------------------------------------—u,--------------------------------------------- <br /> ---------------------------------- ' ------- --------------------- <br /> ------------------------------ --------------- ------------------------------------------------------''''------------------��--'—�--'— <br />� ----'''--''---_'--'''-''''_------------------------ <br /> ----------------------------------- '— <br />` �A\J <br /> F|N/\L |NSPBC —{— Oote-.---��'—��- —����[��--���—_—.' <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT ' <br /> 1601 E.w=°o""Ave. xouWest Oak Street 12*Sycamore Street ooxWest 9th Street <br />' <br /> Stockton,California u`a/,California Manteca,California Tracy,California <br />� . <br />' ^ <br />