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FOR OFFICE USE: APPLICATION F-OR SANITATION PERMIT <br /> f Permit No: . 3.`..... <br /> . <br /> (Complete in Triplicate) <br /> .. . ............ /7 73 <br /> Date Issued .. .r............. <br /> . .. .. ..-- This Permit Expires 1 Year From Date issued - <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein <br /> described. This application is made In compliance with County Ordinance No. 544 and existing Rules and Regulations: <br /> .............CENSUS TRACT <br /> JOB ADDRESS/LOCATION .._...: ��- �......... _... ✓d • �� _...r ... : <br /> . � -... m. ....... . ::. ....:.........................''hone -- ......... <br /> Owner's Name ••••• <br /> I , <br /> Address <br /> Contractors Name ..---.. ........ <br /> - , <br /> Installation will serve: Res clen'ci_q Apartment Nouse Gonimercial QTrailer Court <br /> x � y <br /> Motel ❑Other .................... <br /> --••--••.... : <br />