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FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT Permit No: . 1---= ���� <br /> ------------- <br /> [Complete in Triplicate) <br /> ---�" Date issued �+�-------� •- <br /> - This Permit Expires 1 Year from Date Issued <br /> - <br /> with County Ordinance No. 549 and existing Rules and Regulations: <br /> Application is hereby made to the San Joaquin Local l Health District for a permit to construct and install the workherein <br /> pp compliance described. This application is made in cam _ r._... --- ----------- <br /> ----- <br /> -.--- <br /> - - --- CENSUS TRACT <br /> -- --- ------ <br /> ------------- <br /> JOB ADDRESS/L Tl N -1 ----� ------.Phone ------ ----- --- <br /> - ----------------- <br /> Owner's Name R:" ; .-N <br /> 13' --city ----------------------------- <br /> 1 4�ea- <br /> Address ----, 7 �]- ! ��.37 _ Phone - <br /> Contractor's Name ----- -------- - - - <br /> - y---- " -- - .License # I--- -:�- �.�.-..y <br /> installation will serve.- •-- -Residence Apartment House'❑ Commercial :❑Trailer-Court- , -•------" - — <br /> Matel EJ Other <br /> - <br /> Garbage Grinder __"_-_____." Lot Size -"-------- <br /> - -- <br /> Number of living units:.._--- -- Number of bedrooms ""-------- - - Private ate <br /> -------- --- <br /> Water Supply: Public System and name "----------- Peat F1Sandy Loam 0Clay Loam 0 <br /> Character of soil to a depth of 3 feet: Sand'❑ Silt F] clay ❑ <br /> Hardpan Adobe ❑ Fill Material ------------ if yes,type ----------------- <br /> etc. must be placed on reverse side.] <br /> (Plofi plan, showing size of lot, location ofsystem in <br /> permitted if public wells, buildings, <br /> is available within 200 feet,j <br /> NEW INSTALLATION: (No septic tank orseepage PF <br /> ' Liquid Depth--------- t q <br /> E. Size--,--,-,---,-,-,-,--,,1 --- ----- ti <br /> PACKAGE TREATMENT [ ] SEPTIC TANK I ] # .- . ' - <br /> Nod-Compartments _--_-•;---- <br /> Capacit Type ---------- - ------- Material-.__ :.,. _ -_ t <br /> Y t <br /> k ---- --f-- ....---------------°'.Prop.Line ----------------------- <br /> --Foundation <br /> Distance to. nearest: Well ____------------------ <br /> l Total Length :--- ---- ----------------- <br /> l r. <br /> LEACHING LINE [ ] No. of Lines ------------------ -- <br />