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--- ` <br />� <br /> 60 <br /> APPLICATION FOR SANITATION PERMIT Permit No.s7AAW� <br /> (Complete in Duplicate) e Issued <br /> A t4o !kc�,� stall the work herein described. <br /> T�plica4-ion is hereby made to the San Joaquin Local Health District for a permit <br /> application is made in compliance with County Ordinance No. 549. <br /> Installation will serve: Residence Apartment ouse 0 Commercial [-] Trailer Court Ej j Motel 0 Other E] <br /> Number of living unii�: Number of bedrooms Number of baths ---)--- Lot size <br /> ------------- <br /> Water Supply:. Public system Community system [I Private K Depth to Wafer Ta ble 6,0 ft, <br /> Character of soil to a �Iepfh of 3 feet: Sand E] Gravel V-Srndy-Lloam El, Clay L Clay E] Aclobe <br /> Hardpan <br /> Previous Application Made: Yes E] NoX New Construct ion-, <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is availabW within. 200 feet.) <br /> Septic TaA: istance from nearest weli----?- ------Distan n------le) M f <br /> Disposar Fie�10, istance from nearest we foundation----------A.�_._Distance to nearest lot 1�' <br /> e Wna i 4o -., 's to nearest I I --- <br /> 61 iameter-----k-a 7 <br /> Remodeling and/or repairing (describel: ---- --------------------------------------------0-1--------­­­_��__ ) <br /> A, --------------------------------------------------- <br /> ---'------'--''--''-----''-------'------'--'----'--'-'--------'--''-'------'-''--''-'---' <br /> � <br /> '--'-_'--'---''-'--'-'__.-_-___----''-_''-_.__--'--_''-_.'___''-_-'--''_----__.''-''_-.'-'--. <br /> this application and that the work will be done accordance with San Joaquin County <br /> ordinainces, State laws, and rules and regulations of the San Joaquin Local Health District. ' <br /> (Signed). ------------------------------------------------------------------------------(Owner and/or Contractor) . <br /> _ <br /> By:----------------------------------------- ------------------------Title---- -----------------------------------------_r-- <br /> (Plot plan, showing size'of lot. location of system in relation to wells, buildings, efc., can be placed on reverse side). " <br /> FOR DEPARTMENT USE ONLY <br /> ^ <br /> ' LI-AT . <br /> --------------- <br /> REVIEWED BY.--'--'`--'�---''-'- <br /> It— <br /> BU|LD|N�� PERMIT ISSUED------------------------------------- �@��-�---.-------. D/\|E----�.---_.-_------.--'--_.. <br /> A�a,m�nnsmn6/u, recommendmGona:------.J[J-411 - <br /> ------------ <br /> �-------..._-------_-----_-_-.---_-_---.-----..--._._. <br /> / � . <br /> -------------------- -- <br /> ------------------------------ -------------------------------- ------------------------------------------------------------------- -------- <br /> FIN/\L'UN5PBCT|{JN 8Y_---..-------. ---------------- ........... Date- <br /> SAN JOAQU)NLOCAL HEALTH DISTRICT � <br /> � <br /> /oo Somm 4rn*rico" stroov svo west Oak e,om /ox Sycamore Street « o/* w"*h 'xz^ Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> es-9-2w n=i,e6 vv-2/00 <br />