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^O~ ~~'^~'~ ~~~ APPLICATION FOR SANITATION PERmnr <br /> / <br /> P»rmitnw*��z �-�' - <br /> (Complete In <br /> .......... ......— ................................---. � [oMiUwwwm�y ............. <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 <br /> . � <br /> ' herein <br /> described. This application Is made in compliance with County Ordinance No'. 549 and existing Rules and Regulations- <br /> ............../� .4s <br /> Installation will serve- Residence 0 Apartment House 0 Commeirclal-tjTraller Coutt C] <br /> Motel 0 other <br /> Characterof soil to adepth of 3 feet: SandE]. ' Slit Clay 0 Peat C3 Sandy Loom 0 Clay.Loam <br /> (Plot plan, showing size of lot, location of system in rotation to wells, �bulldlnqs, etc. must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit peri�ittecl If p'"iubfic' sewer is available within 200 feet,1 <br /> EATMENT <br /> A. <br /> (Draw existing and required addition on reverse side) <br /> quin <br /> 1 hereby certify that 11 have 1prep red this application and that the work will be done In accordance with-Son Jac <br /> Cbunty Ordinances, State Laws and1ules--and Regulations of the San Joaquin Local HoaltliK01strict. Home owner or licen- <br /> sod agents signature c"fies the following: <br /> "I certify that in tho performance of the work for which this permit Is Issued, I shall not employ any person In such-manner <br /> as to become subject to Waikman's Compensation laws of California." <br /> (if othert an ownerl <br /> FOR DEPARTMENT U,$E ONLY <br /> APPLICATION <br /> `--- <br /> . --'-- .---------_ —.-----.--^-^---.__ --._--------'—�---'`—._--------.--^ —'----.----_'--.'`—'-------'_'___------'_-------'',---------_--_--- ------- <br /> ---------- <br /> _-. <br /> '----'----'—'—'---'---- ------. ---'—'—''' <br /> —'_—'�nol |nupo�ipmb� —'---------._----'—_'_.---- 1—.—Dpte —. <br /> E8 I] 2� 1~68 Rev.~ 5M SANJOAOUIN LOCAL <br /> ' <br /> 8/74 3m <br /> =_ -_ <br />