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FOR OFFICE USE: <br /> APPLICATION FOR"SANITATION PERMIT Permit No. <br /> ----------- <br /> . . . .............. ---------- - ----- -- ------------- <br /> ---------------- -------11-1--------------­_ - ..... (Complete-in Duplicate) Date Issued <br /> --------------------- This Permit Expires I Year From Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No, S49, -,Z5 -j MQe1*j60S1-7 k , <br /> JOB ADDRESS AND ........ 7_ -------------- <br /> A. t I -S a, __----------- <br /> ozo 0.e4------—-------------------- Phone------------------------------------ <br /> ,Owners Name,.�'an .0�d�4,vv <br /> ----------------- ----- -------------------- <br /> C1ontractor's Name.- <br /> 7- - - ------------)t --- ---------I--------------------------- -----------4-/--------------------.-X-p----4-- <br /> 7 - 15 Phone-- K7. q <br /> Installation will serye: Residence9Ap1,rVenMouse [:] Commercial D Trailer Court 0 Motel ❑ Other 0 <br /> Number of living units: _(----- Number of bedrooms _,Number of baths._1_____ Lot size --------------------------- <br /> Wafe�ir Supply. Public system [I Community system El Private [�epfh to Water Table ({0ft <br /> Character of soil to a depth of 3 feet- Sand El Gravel 0 Sandy'Loam [] Clay Loam [] Clay E] Adobe 0--'Har'dpan C] <br /> Previous Application Made: .-(If yes,date___..__.:-------- No El -New Consf rucf ion. Yes E] Nolk--FHA/VA.. Yes 0 No E] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No'sep <br /> 'jic'tank.or cesspool permitted if public sewer is available within 200 feet.) <br /> -70� , I f <br /> _ Sef` TLULki'. Distance from near4sf well----------------Distance from foundatio6--------------------Material - ------------------------------------- -------- <br /> p- icz <br /> -co <br /> No. o� mpartrents--------------------------Size--------- <br /> 5-L 5!jjqy 1 —------------- -----------Liquici depjh----- -- ----- Capacity... ---------------- <br /> D'ISPDOSDI Fiel•d: Dista6ce'.fro-m n-e,ef•esf7werl7'gt'O'--___Distance from zGu7nQtion__,/j&9----------Disfan-ce to nearest lot line__ <br />