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}vo\' <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> � � Omo�a�\ /� <br /> (Complete Duplicate) <br /> Date Issued -��� <br /> Ur " <br /> Ahplication <br /> is hereby made to the San Joaquin Local Health Q|��cf for o ponn|f to construct and in�uUthe wo,~ herein described.mode in compliance with County Ordinance No. 549. <br /> � <br /> JOB ADDRESS AND <br /> [h°ner'u Name xu�,� �^� � � � <br /> ------''v------'=~��-~'','-~ -------------------------------------------- --------------------- -------------------' Phone------.___�___ <br /> Con <br /> Installation will serve: Residence ---- ------------------- Phone--- <br /> Apartment House F-] Commercial E] Trailer Court E] Matel' [] Other E] <br /> Number of living units:9__1__,N umber of bedrooms --/---'Lot size ------- ---------- <br /> W-- Supply: . -_. �� = <br /> - ~r.~. ~~ ..~..' �~,. . Private E] uvprn to Water Table <br /> Chunx�e, of soil +om depth of 3 feet: Sand [] Gravel~� 0 Sandy Loam E] Clay <br /> Loom Ej Clay E] AclobeeHardpan [] <br /> Previous Application Made. Yes �o* Construction: Y� [� N . Yes [� N- ^ <br /> /,�� � ^�~��� ��� `� <br /> TYPEOf INSTALLATION AND SPEC|RCAT[>KS: ' ' `�� <br /> (No septic tank m,'cesopww/ permitted RPublic sewer isavailable within 200 feet.) ^ � <br /> � <br /> d'spos <br /> Distance from nearest w°U------Di�a"ce from foundation-------k4u+n�oL---------__---_. <br /> No. ofcomportnvnt�-----_-_Sb�-_----_-~_Uqui66opfh_�� -\ '-'�Copuc�v--''---'/ Distance6nm neu.o� weL�'''��'Di�ance from [uun6ufion_-''-'--� i~^n r`h, neure� ` |ina`-----_ ' <br /> � <br /> Number of lines- Length of each |i Width oftrench <br /> Soap P�� Did�nco tv nvon,,t �u - ` <br /> . ' �� ��� _ -� U <br /> � . <br /> Number of pifs . --------------Lining material Size: Diameter-----44;Z--------Deotk- �> <br /> C ,� ' |: Distance from no°� U <br /> st �� -.----.-Distancefnom foundation--'_- U <br /> ���� ning mu�rioL----.---_-- `~ <br /> LJ Size: Diomvfer------------------ ------.-------------Dep+h----------------------------------------------------Liquid --''--'--'.gu6. <br /> Privy: Distance from nearest well------------------------------------------------- from nearest iui/d|ng------------------------------------------ <br /> Distance to <br /> ---._-___--'- <br /> Distance +o nearest lot |ina'''-��''--'-______��______.____.______.___________._________ <br /> ' <br /> Remodeling on6)o� repairing �e`�n� '\ <br /> --- -------- 0..... -------------------- ------------------- <br /> - <br /> ------ -- -- <br /> .- <br /> -_f"�� <br /> _-.'-��__--- .-- <br /> -___-__-_-_' <br /> -'- hereby certify that I have prepared ibis application and that the work will be done in accordance with San Joaquin---'-''�---'--'----'--''---''--'-----------'--'-''-----------------'— --'--''� <br /> / <br /> County <br /> ordinances, State laws, anc�LAIes and regulatio f the San ipaquin Local Health District. <br /> ��nmm�. <br /> By:--'----_----' ---'---'-'---'----' J ' �� -�-' —'----- ---- <br /> (Plot <br /> racforl <br /> ~u- <br /> �.` <br /> .` <br /> � <br /> � <br /> p�n. size of lot, location *fsyoh»min raf�nto ~ o|� uYngs - �--n6m placed on reverseside). <br /> FOR DEPARTMENT uS� ONLY <br /> ------------------------- <br /> APPLICATION ACCEPTED BY------ <br /> '----'---- DATE--'--- -- ..RBEYEO BY . _ �_________�___________��--''-'''-'- DATE''- <br /> ------------- <br /> BUILDING PERMIT ISSUED_._--_------'-_ _--_-_.__- DATE_ <br /> Alterations and/or recommendations: ^ � -------_ -_- <br /> 777 <br /> ---- ----------- '-- ---------------- <br /> -------------- <br /> ---------- <br /> ---- -'--' <br /> -----' � -''�-''''-'--'-�'-''-_.'''--- --' '-- <br /> ----------- <br /> FINAL INSPECT/ Date-------------------- <br /> ------------------- <br /> SAN <br /> _ ___. <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street /»e Sycamore sv=°+ u|* North "C" Street <br /> mo"k+"". CW/;","/° Lodi, California Manteca, California Tracy, California <br />