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. . <br /> X,Al <br /> '��� SANITATION��� �T � PERM[T ��m� n <br /> in Oumkumtm Date |au � <br /> V / / <br /> ~^ 'Application is he e y made <br /> ~�- Joaquin Local Hau�6Di�r�ffor opann� construct �erindeori6od. <br /> This application is made in compliance with County Ordinanc/)No. 549. <br /> Owner's m <br /> ~~ '---''-----'-'"~�a -------------------------------------------------- <br /> Address <br /> ` � <br /> ''--='^-- <br /> --------- <br /> Contractor's N ,-_-.__-----------__-------._.. phone----------------------------------- <br /> R <br /> . . --'-- <br /> ! Apartment H��.� Commercial � Tm�� C�� � �� � Other 0 <br /> Installation will serve.;Number ofliving units: Numberbedrooms—Z.of �Num6o, ofbos '�/ <br /> _ Lot size -----����-^���,�~�~ ----------- ------ <br /> ! Water Supply: Public;-S'ystem . *Community system Ej priva � to ��r ��o ��� � <br /> (���r � s� � a d�� � 3 feet: Sand [] Gravel El3a�y`Loam E] Clay Loam [] {lay [:1 Hardpan [] <br /> Previous Application �a6o� Y� � N*� (������ Y� � N�� <br /> p^~^^~' �- ~-� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> ' permitted if public sewer is available within 200fee+J <br /> ce from nearest <br /> ! <br /> Septic <br /> � � -- � <br /> �de�f�� � � � ---Capacity ��- <br /> No. oFcompur�nunt�.. ~- �-_-..S�u w � �A�-Uqui <br /> Disposal Field- Distance from nearest well----------------- from foundat�n '-''-_-'Distance to neona� �tU n r ---------------- <br /> Number m' lines---------------------- ------------Length of each ||no . . Width of - <br /> ------- <br /> Type . <br /> of �|fe, mot�h�| Depth of filter m�+e�oL_--._-Tot | length----___—.-__—.- <br /> Seepage Pit: VDisfance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line----------------- <br /> 0 Size: D."m=.e. Dept ________-- -----------;.....Liquid Capacity <br /> Mstance from nearestoo ",/ <br /> ' and/or ------------------ <br /> 01---- ------------- ----------4-------� <br /> ` by certif th I ha prepared +his application and tha he work will be done in accordance with San Joaquin County <br /> State la' nd rule an regula of the San Joaquin Local Health District. <br /> � re=°+_ <br /> '(Plot plan, sho size �& � �� �* R�md on reverse Ide). <br /> FOADEEARTMENT USE ONLY <br /> _---_--- DATE-. � <br /> __ <br /> _ <br /> APPUCAT|{ N ACCEPTEDDY- - ----- �TE- ' � ____,________. <br /> -. <br /> ------- <br /> REVIEWEDBY--------------------------------------------- �'' D ------- <br /> BUILDING <br /> _ <br /> 8U|LD|NG PERMIT ISSUED-------------------------------------------------------------------- ----------------- <br /> _ ------------ <br /> DATE- <br /> ______-_________.___. <br /> Nh,r*ti*noan6/*, recommendations:------------ ------------- ------_ ------------------------------------------------------------ ------------------------------------------------------- <br /> . <br /> ------------------------------------------ ---_ ---------------------------------------- --------------------------------------------------------- ----------------------- ---------------------------------- <br /> }� .______''--''-''''_-'--'-'''--''�-'--''''--'''''-'''----''-''----'-'''---�'---''-''-'-'----''' <br /> ''-'—'''''--'''--_''----''--''---'-'-'-'''--_'''-'_--'---'�-'--- <br /> ----``````-`^```-`-`-`-```— <br /> ------------------------------------------------------------------------ ---------------------------------------------------- -------------------- ------------------------------------------------------------------------- <br /> V <br /> FINAL INSPECTION BY�_----' '-------------- Date------- A�---------_---_--- <br /> ( LOCAL HEA�HD�TR�T <br /> S/�� JC���'U N <br /> � /su S""m American Street amWest Oak Street /sz nv"°m"re Street uw North 'Cr Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> ES-7-2w /().,a x.,u°a vv�2/00 - <br />