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� <br /> ~4 <br /> �jP�LkCA][ ���� ����R PERMIT Permit N — � <br /> � ' <br /> 0 <br /> (Complete in Duplicate) <br /> 0Y " Date |�mm6 <br />\ ~ | <br /> is hereby made to the Son Joaquin Local Health DisfHcit for u permit to construct and install the work herein described. '* <br /> This application is made in compliance with County Drd|nonca'No. 549. <br /> x, Pho-ne <br /> |' <br /> --------------Owne <br /> �� ��4 <br /> Con�ucfor� Nume----'_--__---._- .—.. ���..�---_-_--__.. Phone------------ <br /> - ` <br /> |��n � �� R�|6eme�� Apartment House E] Commercial E] Trailer Court E] Motel Ej Other E] <br /> Number of living` units: -------- Number of bedrooms 'j--_~N^�~~. - - , 1—' Lot size -_-- ._----' <br /> .—.. <br /> Wator <br /> Supply: Pu6||cy Community ,y,h,m � Private F] Depth to Wafer TnTable -------- f[ <br /> . <br /> Character of soil to a depth of 3 feet: Sand [] Gravel 0 Sandy Loam E] Clay Loam [] Clay E] Ado, Hardpan [] <br /> -T <br /> Previous Application .Made: Yea [] New Construction. ' \ ] <br /> NoF . � <br /> 'r/�r <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic k | permitted if public sewer is available within 200!�,et_) <br /> Disposal Field: Distance fro 5r;st 'well---- ------Distance from 4oundation- --------- <br /> th <br /> Width <br /> -14 <br /> v .� ' ~ <br /> ' r- of �| 'mo+e�a| '" —�--''Deo+- of ��n, �o+nr'o| ' '''To+a| |onot6 - -^----- <br /> � ` ~e| from ' <br /> ---- <br /> Seepage Pit: <br /> ' <br /> * <br /> El Numberlof <br /> Ceep�oL Distonce�,6nnn Inoore,twell-----------------Distance from foundation ---------Lining material------------------------------ � <br /> [] <br /> Size: Diameter--------------------------------------- -----_--.- -----------------------Liquid Capucih^_-��—_--_.gals <br /> . <br /> Privy: Distance from nearest well ----- -----------------------------------Distance from nouresi building----------------^-_''----_''- <br /> [] D|sfanco ,est lot |�ne---'''--�� —'''- ~ ---''-_.-'--�''-''-'-_--'-'',--_''-'_— <br /> � ^ ' <br /> Remodeling and/or nepoi6ng (describe): .-_'-''—'' -''-_ ' -'---' -'__--' <br /> ~�- � � <br /> --------''--'''�--'------''--''-,'----�-~��-��"--- <br /> ------------------ - -------------------'-------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> --------------------------- _---.�__.--'--__._ �.-_-___.-_.''-_-__.-_..L.__-__-'__-__ _---.—.�--_ -- <br /> I hereby ' have prepared this application and that the work will be done in accordance with San Joaquin County ° <br /> n,6ina000s. State laws, and rules and regulations ofthe San Joaquin Local Health District. � <br /> ..+--_'_-'_.--. and/or Cmo�aw+or ° <br /> \ '1-_ --1�^'-' ^ <br /> --------- <br /> (Plotplan, showing <br /> -w41 of lot, locafion of stern in relation to wells, buildings, can be ��e� on ~ <br /> ^ placed ` <br /> FOR DEPARTMENT USt ONLY <br /> � <br /> ,`rruCA//Om ALCcr/Eu BY-------------------------------- '------_-''---' DATE---------- <br /> REVIEWED <br /> ''REYEWED BY----------------------------------- -------------------L.-_— -------------------------------- DATE------------------__~~--------------------­ <br /> BUILDING <br /> __.BU|LD|NE> PERMIT ISSUED--------------------------------- DATE----- --'__�__''-''-______.__ ' <br /> Alteratiunoan6/nr~roon,nman6atiwho;.-. -- - -- ----.----._.-' - --' ' <br /> a��-��'' -~--�r—r'--~-r----'----~r''�—�---' -'-~- - - <br /> --'4-�'��'�o��--'',��9���--��w�=�^'---------'-----'' <br /> -------------- -------� --- ._-------.. -. <br /> —'-''-''—''-''—� '-' ---'--''-' � ''__ <br /> FINAL |NSPECT|ON ----'�- Dot�-_.-�����-��.���-.�-.-���,�.1�--',-'- <br /> ' x <br /> SAN JOAQU)NLOCAL HEALTH DISTRICT , <br /> wu s=+h American S+=of 300 West Oak Street /32 sv`°mo= Street nw m"*h '`o^ o»=of <br /> Stockton, California Lodi, California wun+ocu. California Tracy, California <br />