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� .. <br /> APPLICATION FOR SANITATION PERMIT Permit No. � <br /> k��mo�f <br /> ' ' in Duplicate) __. Da� |svum6 ...Y/ <br /> Applica-l'icin is hereby made to the San Joaquin Local Health District for a-permit to construct and install the worKkhn r described. <br /> / <br /> This application,is mpeje�in-compliance with County Ordinance No. 549. <br /> JOB ADDRESS P k <br /> Owner's m <br /> Installation will serve: Reside Apartment House E] Commercial F] Trailer Court E] Ki-ofel-E] -Ofher 2410/0.10L_ <br /> Number of living,unifs: Number of bedrooms umber of baths ---(D-- Lot size <br /> Water Supply: Public. i�stem '0-66mmunity sy�tl� Private E-]' Deptl­f't6"Water Table 4%)ff. 4- <br /> Character of soil f0i a'-clepfh of 3 feet: ind 0 G Ho' Sandy Loam E] Clay Lo' El Clay F <br /> Adobe B-<erdpan <br /> No 0 New Construction: Yes [] No <br /> Previous Application Made: Yes <br /> TYPE OF INSTALLATION AND'rPECIFICATIONS:--,", <br /> (No septic +ank'o'r cesspool permitted if public sewer is available within 200 feet.) <br /> ic i-Ta 4: 'Distance from,.nearesf well------------------Distance from foundation------------ -------Material <br />! No..cfcompartments---- ------ ------------Size--------------------------------Liquid dep| -------------- <br /> ------------Capacity'---'--- <br /> ` ;J+~ncv fnom naum,+ W'0---------- - <br /> ' |---- —Distance from foundation------------'-------Distance to nearest lot line---'_-' <br /> Num6e, of lines -'''-'''- ------------Length of each line--------------- VV�f ofhanrh---_---.--' ' <br /> T�* � �� material p� |' <br /> ka g Disfg'nc-e fo'6eare-st well'zw-------------Distanc m foundation----,/O..".-..Dislance to nearest lot <br /> Number of pits-----/---------------Lining maferial'A&IJ --- --Size: ----Depth-s <br />! ' - J' ' Liquid Capacity ---------gals. ' <br /> Privy: Distance from noo�u weU.---�'_''--- �'''--Distance from nearest <br /> , <br /> building'-'-''_---__----'_ ' <br /> E] Distance | | ^ <br /> Remodeling and/or: <br />. . -_� _'- <br /> � � <br />� �� _'___----''-_ ~ <br /> --------------------------------------------�­'­''----- <br /> I hereby certify that I have prepared this application and fhat.the work will be done in accordance with San Joaq in <br /> ordinances, State laws, and rules and regulations of the San-JoaA4in Local Health District. <br /> (Signed DAY& NIG14T <br /> -------------------------------- <br /> (Plot plan, showin sl e of lot. Ioc11?#A0.$)94"in' relation to Lills, buildings. efc. can b�e placed on reverse side). <br /> FOR DEPARNENT USE ONLY <br /> ---------------------------1. <br /> -_.-----.----_--_-.--------------'-----_--'_----'_-_-_._._--_--_._._- <br /> ------------------ --------------------- -'--'- ---------------------------------- -'-'� ------------------------------------------------------------------------ ------------------------------------------- <br /> '--''-'''-'--'''--''--''-''----''--''-'''--�--''---''--''_---��-'-'''-_________-______ / <br /> BY:_,4_,e"147V.,4f-- <br /> FINAL INSPECTION ' __ --- Do+,.J�^�� <br /> � <br /> SAN JCAQUUN LOCAL HEALTH DISTRICT <br /> m# South Amer;can Street 300 West Oak Sffeet _ ~ /32 Sycamore Street 814 North "C" Street <br /> Stockton, California Lodi, California ~- J Manteca, Ca/�pmi* r�� �� <br /> . � "m|* <br /> . / <br /> °54°^`W""" = � <br />_ { <br />