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' uz/ <br /> "��-x�c <br /> � APPLICATION FOR SANITATION PERMIT Permit No. -------- <br /> � <br /> (Complete in Duplicate) Date Issued <br /> ' \ described. ` <br /> rict for a permit to constr and <br /> 'installt6u work <br /> Application is hereby made to the San Joaquin Local Health Dist 4-9 u 0111 <br /> This application is made in compliance with County Ordi6ance No. 549. <br /> JOB ADDRESS AND <br />' L[XC�T|L) <br /> a­!�-OP� Phone,&t!��----f <br /> Owner's Name--_--------------------------92, ---------------------------------- <br /> Contractor's Name------------------dl-A House Commercial D Trailer Court El Motel E] Other <br /> Installation will serve: Residence�& Apartment 4!!�p <br /> � <br /> Water ~~rr,' Public ' r­l-- Community system C1 <br /> Sandy Lou 0 ]wyLoam [I Clay E] '=~~ X~_ --' ~� <br /> Character of soil to a �.� � 3 �� �n6 P G�� 0 <br /> �� <br /> � <br /> Previous ' FK�/����NS - ~~-�-° °~�-- ---- <br /> � ~~ E-��p \N�7�LL�TK�N`�WD'SP6C\ �' <br /> (No septic tank or cesspool permitted _e V <br /> Disfance, from neares I ----------Distance from foundafion-.4iX---------- 1 ;�A- <br /> )1 <br /> � ��� lie sewer is available within 200 fe—eA, <br /> '�° of compartments-' rest �� xm----------------- <br /> Distance <br /> -''-_. <br /> Di��nxo �om nearest well from foundation--------------------- toneo <br /> Disposal �6. Width of �enc&'''_- <br /> �- <br /> ____.._._-. <br /> Num6orof lines----------------------------------- c� eoc� |�o -'''-'-'-- - ------------------------------- <br /> ----------------------- .. <br /> Tofo| `�"y,. <br /> TvPa ^Ffi|+or mo1erimi ---Depth of filter material <br /> Distance w:L/ ' xto nearest�1o�1ine-1--0-7 <br /> � � � <br /> S~`'-=upit .- ------------ <br /> Number <br /> ___ <br /> Num�urofp�,_ ^�� ''-�n�g m�+�n ^ze: -_ __Dopt�.. <br /> t a ��/� Distance from �� material /s <br /> Cesspool: <br /> ` ��r;vy. m neu= ~e, --- <br /> \ ustanco to nearest ~' ^^~- -'-- <br /> ---------------------- <br /> � Remv6alinand/or repairing (describe): <br /> ----------------- <br /> ' -- +h'�iplication and that the work will be done in accordance with San Joaquin County <br /> % prepared this <br /> u oaquin Local Health District. <br /> -------------------- <br /> ^ (Plo+ pla s...w-in size of-_lot, localrio of system i relation to wells, buildings, efc., can be aced on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> � �----------- <br /> DATE --------- <br /> APPLICATION ����r/�u u` ------ —------ _ __�___________________ <br /> REV|E �ED Dy-_ DATE <br /> -_.z�-'------'--------' <br /> BU|LD|NEPERMIT ISSUED------ <br /> ___________.._______--_--'___._ <br /> ' *nera�ono renommon6m+�no '''�--''-_'''-_----._..-___''--' ________________________---_- <br /> p"a no.,aq u,n L o c a I�H <br /> 10 <br /> Feed <br /> m 7irel <br /> .__------'----_-._--..__--_-'_-_----.�-._._.--__-''---''� �_-----_---__-_-_--__-- <br /> � '-_'''-_---_'''_-_''_-.'''-_-'''-''-'�-'''--.''-_''� �---- -- -''''''__---'''__.'-_.-_.--_-'_- <br /> � __�___���__���_�_�___��__���___��� <br /> .-_._-_.__-'--_-� � <br /> --- <br /> ------------------------- <br /> -------------------------- ~ '--------------------------------------------------- <br /> F --------------------------------------------------- <br /> ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> FINAL INSPECTION BY:--'-�-' -----------'--J'--,---_''-''_- <br /> SAN JOAQU\NLCCAL HEALTH DU <br /> Cr <br /> / <br /> � <br /> Streetmom^*h "C" Street <br /> mV South American Street" mmvv�� �° S�"� /su Sycamore r�, California-- �a" " California ,. <br /> ^ ��m�"". CaliforniaLodi, California �. . <br /> es-9�-2w B-5/ Revised v/-2/00 <br />