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JOR OFFICE USE, �������UK��� ��N� ��8� PERMIT Permit No. ' <br /> "a�� Nc m pi et4 in Te <br /> Date Issued <br /> / PermitExpires1 Year FroThis � <br /> � -- <br /> - � Loco\ Hno| �|' o it to construct and install the work hherein Application is hereby made tothe San Joaquin dnQ Rules and R�Q |o�unm <br /> J' 6e�. T�| tion is no6e in compliance with County ordinance No. 549 o"" mds ~ <br /> // <br /> ' <br /> ` <br />' J[>B <br />|`/ ADDne�a�u� ---' ^ -----'- .^ p'phone <br /> � <br /> Owner's N �� �y -' � � /-V'- <br /> � <br /> -` <br /> -_e <br /> � _=��Z <br /> Address '� °-= � ~ -Z --' _.^._—'_`.-__--- ----- Phone �� <br /> �-��r _ _-_~L�unsa # <br /> Cun�oco�'sNone --_. ���-._ _--- <br /> -------------------- <br /> Installation will serve: Residence 04_Apor*nnntHouse[] Commercial Fj?rciUemrCourt C ''--- <br /> Motel F1 other -'---�-'-'—'---- <br /> / ------------ <br /> Water <br /> Lot Size —S--aAV�0�--------- <br /> Number <br /> ''- <br /> Nom6er of living un�� r—' Number c� 6^e��room�� � -.-/�o6�ogo Grinder ---- <br /> Vo+mr Sopp|y. Public System and mone -- ---'/ ' <br /> ____._ <br /> PrivateL� <br /> ' <br /> Sand'[] Silt[ C|oy M . Peat 0 Son6v <br /> Loam E] Clay Loam R <br /> Character of soil to depth of feet: <br /> � Hardpan Adobee-[-] Fill .. |fyes type ---------------------------- <br /> must <br /> . <br /> --.-- <br /> " --- -- placed <br /> nsystem (n a| �n to wells, buildings, ~.^ <br /> \P|c� plan, showing si'ze of lot, location � � � �u6/i� sewer is available 20 <br /> 0foot> <br /> NEW INSTALLATION: (No septic seepage pit <br /> _� Liquid Depth --------- <br /> PT|CTANK� ] �u�,��� ____-__._. � <br /> � PACK�/�2TRE/g7WENT � ] / -_'— <br /> `�------ ---------------------- No. Compartments --------------------- <br /> Capacity ----'— `vPe -------------------- NG*eriO <br /> *� <br /> � <br /> --Foundation prop. L�� --'—'---' ~- <br /> [M�anoa to neovmg` VVoU —'_---'—'--' ' -----'' N� <br /> LEACHING LINE [ ] No of Lines ------------------------ bemgM, of each \|ne--------. Total Length ___--'-'-'; <br /> /�^�`'/ ----------- <br /> —' <br /> —_Deo�h Filter Material <br /> --- <br /> —_- <br /> . <br /> 'D' Box ---. Type �Ko, N ,��o\ --' P,opaMy U <br /> -------------------- <br /> Distance to nearest: Well .. Foundation ------------------------ <br /> Number <br /> ------- <br /> Numb� � - Rock �U��' <br /> — <br /> �—eo' <br /> ----N'm <br /> SEEPAGE PIT Depth Diameter ' ' -'_�ock0ze -------------------------------- <br /> Water <br /> ._—'_.____ <br /> Vo�r Table Depth -------------------------------------- <br /> Distance <br /> _---'------- <br /> Distoncetoneovem` VoU ---'—'-------''Fomndction .)Pmp Line ---------------------- <br /> �_]... <br /> J-�� <br /> 9 <br /> _- D�NON�rev Sanitation Pormitf ' -.- Dote ---.--.-'---_ <br /> uepoc Tank (Specify Requirements) -------'---------- ---'- <br /> ���t�~ 9--� . ��~��.- � ' --' <br /> ---__ (specify Requirements) , — �� <br /> . ' v�~~- <br /> / ------------ -----------------(Draw eximing on6required addition on reverse side) <br /> �� �����nm� �� �w �� �U he done � ���� with Son ��n <br /> � I hereby certify v6�Y � �m«� �'e��r�x� �«o- '� Regulations of �h� San ��m�w�m �w*m| �e�l�� ��w�M^�^ �wnmw owner or N«wn- <br /> Cownty Ordinances, State Laws, and Rules am <br /> sod agents signature certifies the following; � iissued, l shall �m: �n�1m� any ���amu in such manner <br /> ' '`| certify that in the performance wfthe work for vvh1ch this permit � ��um , <br /> as mpwnyw�on laws of California." <br /> ��� --_--.- uvvn�r <br /> 5ig ___�______ <br /> �� �r __.-. �mn ------ ------'---- <br /> Dy -.-----------'—'---------'--'-- <br /> (if other than owner) <br /> . - <br /> FOR =^,A..~.~'. --- <br /> ONLY <br /> muuu/mG PERMIT" ..~.^. ----------------------------------- <br /> _Y------ 7f ----------------------------------------------------------------------------------- -------- <br /> Final Inspection ---- ------- -- -------j --- -- ------ ------------------------------------------------- -Dat <br /> by r i__c ------- -- <br /> SAN J AQUIN LOCAL HEALTH DISTRICT <br /> EH. 9 1''6Q Rev. 5W\ <br />