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` - APPLICATION FOR SANITATION PERMIT Permit No. ....... ^�^�-�~- ' ��mp|�� Ou�|��f�� ^ Ou+e Issued hereby made Applica,lion is mo6n fo the Son Joaquin Local Health District for a permit to construct and install the k herein described. This application is made in compliance with County Ordinance No. 549. JOB �DDRESS AND LO"CATION-_,j�-.1,----��_ ------ -- ---- ------- Address------------------ V _3 -1-all 11----------------------------------------------- ------------- ------ Installation will serve: Residence Apartment House F] Commercial E] Trailer Cou rt E] M I Other idence Number of living units: A----- Number of bedrooms J---- Numb6r of baths __/... Lot.size ------------------- System PriV. Depth to Water Ta Wafer Supply: Public system El Community a te 1K ble ft, I Hardpan E] Character of soil to a depth of 3 feet: Sand E] Gravel [] Sandy Loam [-] Clay Loam El C16Y E] Adobe IV Previous Application Made: Yes [-] No X New Construction: Yes.0 No E]� . TYPE OF INSTALLATION AND SPECIFICATIONS: I , . '.* , i . i i (No septic tank or cesspool permitted if public sewer is available within 200 feet.) 'Ic — - _',_t-_tcorens---------Size_----_------'Liquid _-"--------- -----..Capacity-'_----.-' ' �~�"� 4is�po,al RaR6 Distance from v�| Distance' from fou SLIF,------- Dist'ance to nearest ot lige line' 6 _ �Number of lin .D�o+ � | o,- ~ + o( - . . oto| length-- Typecf filter mofe | .. -_ '--'-- i Soopnganearest ^�+ - Y� P�� Distance +n noons+�wpU'---''-''D�t Distance foundation ----Distance to nearest lot line''---'- ' 0 Number ofpits--.-----Uning material .--.�------Size: Diameter _..--'----Depth--.--__-_-. Cesspooc ' Distance from.nearest well-- Distance from foundation rLining material- �~^[]v �,Size':il3 -Dp+ � privy: Fj� Distance to nearest |o+ .� |i - . � ` . �^ _-__ — _ �I Remodeling and/or repairing ��euchb�:� � --------------------- ----------------- -- -__. --------'---'----'--'--'---''--'''-''---'----'--�--'---''--''-�''---'--__----_--__'-'''-- '---''--'''----'-'-'-----'''---'--''-- ---'--''------''--'----'--'-'-'--'---'-----''-' - .-�__________. .__._______.___________.______.___________._.____________._'_ �r I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances. State laws, and rules and regulations of the San Joaquin Local Health District. / 'By:--__-__'______.--_.'''----''—''---''-''''--_.-''--'''-_'''-(Title)-----�-�--.''_---''_''-_____ ! (Plot plan, showing size of lot, loua+ton'�mf system in ,ala+hontnwells, . n+c, can be placed on reverse si6o).---- t FOR DEPARTMENT USE ONLY ' BUILDING PERMIT |S3UED-'-------.-_-.-_-. �'��'-.-------. DATE---.v..�--,__.__., � Alterations and/or recommendations:------------------------------ --------------------------------------------------------------- - ------------------------------------------------------ --------------------------- _-_-_-_-----_�-_.--'_--_-'--_---'_--_-----_----__._--_--___^.__.-- ^ --_----'''-_-''_-'-''_-''---'--'''—'--'''^-'''-_''-_'''--''---''--''-_--_-.-_-''-'--_''__'__.- . , .—_—_--_--.__-._._--._-._--.--._---_--_-_----'_----._--_---- - ' -__-_ ---.--''-'''''-''-'-''' --'--'''--'-'-''-''''--'''-''-'' ------------------ ------------------------ FINAL --'''-- / '-'--''--'- ��L INSPECTION 'BY:''---l - '-'--- �� l''— 1—~'�7.�� - ' 1A SAN JOAQUDN LOCAL HEALTH DISTRICT /30 south America" street 300 West oak street 132 Sycamore Street o|* Horth "C" Street Stoukt"n, California Lod(, California Ma,+^~o, California Tracy, California