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Permit <br /> APPLICATION FOR ��� �T �� PERMIT � <br /> SANITATION <br /> in Duplicate) Date |euo6 -�Z/4_7_ <br /> Application is hereby mo6m to the San Joaquin Local Health District for u permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance o. 549./ <br /> JOB ADDRESS AND LOCATION- --------------------------- -- ------------- -----------S <br /> -----------Q, <br /> Installation will serve: Residence Apartment House E] Trailer Court E] Mofel El Other 0 <br /> Number of living units: J- Number of bedrooms --17,^- umber of baths j---- Lot size <br /> Wafer Supply: Public system El Community system El Private F4 Depth to Water Table -Of—f <br /> Character of soil to a depth of 3 feet: Sand Ej Gravel F] Sandy Loam El Clay Loam EJ Clay [:) Adobex Hardpan Ej <br /> Previous Application Made: Yes E] No New Construction-. Yes El No FHA/VA; Yes E] No <br /> TYPE OF INSTALLATION AND'SPECIFICATIONS: <br /> (No septic tank or'cesspo'ol permitted if public sewer is available within,200 feet.) <br /> � � � <br /> mo. of compvrnnvm��-�_-._--.~. .__---.—_-_ ` .� . <br />� " <br /> Distance from na*n:� .uU_--_.-Distance6nm founJo6on'-_''__.'Distance +o neonsm �t |im�---'__ <br /> '�p°~^' ' Number of lines-----------------------------------Length of each line- . ----------Width of trench .- <br /> a e Pit: -est well is ance o�?e�- Di t )ce +<2�earest lot line-- <br /> i LJ <br />^ -° ~~'^' —'---� Liquid� Diameter -- p `~ from - <br /> -_� 'r�'� � Q�t nco �,pmneo�v ��n- <br /> Distance to nearest lot line <br /> --_—_-^ ' ||m�--_---__--____-__--_.-__-__-��'_-_-''� �_''-'__---' <br /> op�irg a , e)� �Remo6e6ing and/or r � <br /> ............---____.-�___.__-----__.-__ -' <br /> ^—'—'—'--------------'`--------------'-----'--------------''--''--'-___-'-'--_-__- <br /> __--__--'---_'__.__._-'--'-_--_-''-'-'-__.-'-- <br /> ' <br /> - <br /> | —�--'---------''--'--'______..-_.---_ <br /> that | 6avn preparedt6is application and that the work will be done |naccordance with San Joaquin County <br /> ordState inances, <br /> and rules and regulations of the San Joaquin Local Health District. <br /> P�n ~ <br /> -'---''�'-''-----'-_.--_.. and/or Cuntn�to, <br /> Y. <br /> '-----'---''-'�'^~p'-'---'--''-'----''-'---'-' <br /> -----------��__._______---_.'---' <br /> -----'--- <br /> �� ��. �m�nqsize of lot, location of system �� relationto ~ellbuildings. etc., can 6oplaced nnreverse si6e). <br /> (� <br /> FOR DEPARTMENT USE ONLY <br /> ! <br /> APPLICATION ACCEPTED 8Y-''''-' <br /> REV|EVVB} BY----------------------------------------^----------- ----- ------- - ---- -------- -- ----------------------------- DATE-----7�---- -------------------- <br /> 8U|LD|N�� PERMIT |�SUED.___-_--.-����_c�'4r'z��»e�.�_--_------ DATE.-'____..__.__----___- <br /> Alterations mn6/o, ------------- -----------------------------_ <br /> . -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------_ ------------------------------- <br /> ----------- ----------------------------- ---------------- ------------------- ----------------- ------------------------------------------------ ---------.---------------- -----------------------------------------------.. <br /> '-'-_'--'--.'-''-_---'-''_-'--''--'----_-'-_.'-'-''--_''_-''-_'''-----''_---.''-''---------''--' <br /> '_-----_-_----------_-----_-----__'__-_--._---.___--_-_._—.--.----.—_.- <br /> � �^� ~~ <br /> D�+� --------- ��� '� ~� -''-'-' <br /> FINAL INSPECTION BY:.--- -- ----.��----- <br /> SAN JOAQU\NLOCAL HEALTH DISTRICT <br /> /30 South Amm/*o" Street 3ooWest Oat Street /sc Sycamore Street 81+ wo*6 "C" Street <br /> S+o"kfo". Ca|/f",m° Lodi, California Manteca, California Tracy, California <br />