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°�� , APPLICATION FOR SANITATION PERMIT � - - � (Complete in Duplicate) , g� n to the San Local Health District � u permit to construct and install the workherein described. T�� application is madein compliancewith County Ordinance No. 549 � . JOB ADDRESS AND LOCATION «�e -- -~~---------_.--_—.--' Own r's N Phone—.._—.-_____ ~` *du _.�___..__�_____..___.._�-___.__-- Cont�cto,, Na ��>��.�"�..—�--_--_-_.__..___ P�ona.-��-�.-f�-7�- Installation will serve: Residence Apartment House El'"-Commercial E] Trailer Courf 0 Motel El Other El Number � |h� u��' � Number � E�� r � ��s �� a ' ' �� °�&` ` —~�~~~~~.~~---------^ ~u� Water Supply: Public system El Community system [] Private - �=� p Character of soil to a depth of3feet: Sand El Gravel F1Sandy Loam E] Clay Lnum E] Clay [j Adobe J�n� Hardpan [] / x TYPE tJP.INSTALLATION AND SPECIFICATIONS: (No septic tank o, ces*poo| p�rm�f�6 �fpu6|/c *mwmris available within 200 feet.) ^ ' ' � Se fi Tank: A ` `~oopoo/' uonunoy from nearest well Distance from foundation--------------------Lining material � ~ [] S�o' D�m=+ec__-_—__._---..Dep�-_.—___. ------------------------------- ' � Privy: Distance from nean:sf-m=|L—':n---------------------------------------Distance from nearest building'__—'--___'__— � El Distance +unearest lot line------------------- Pit: Distance to nearest weL_.--.—_-'Distunoo fn5m foundation--------------------Distance to nearest lot line----------------- Number --'-_- m o of pits Lining material SDiameter Depth Di, mL|�e|6� .D�d�nco from�.nomreg`�eU-^�^�_'—� ^6 ' Number of lines--------------- Length of each |i YVi6th of +nench— .J2__y./,------ ' r Typo of filter material Depth of fi|tn, muto6*i-_Id" -------- Remodeling -6 .-----Ramodel �nd/o �. �-~ �� _ � � . -- ------------------------------------------------------_—__._- ___.______-__`.—_____.---^—_^___---__..___.—'-_--___---___..__--_--_---'-___..__._____-�- ' -------------^----'----'--'-----------'--'----'''--'--------------'-----'--''------------- '--_—_.—_'_-----''_—�—'___.''-------____--_—.--'-_—..__--__----__---_____—__...__.____-_. ' | hmve 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: ~_ _ _-----'''—_.''''--__--..__-_—._- ----- ----- ------ ------- —_—' (Plot plans, showing size of lot, location of system in relafion to we|ls'. 6uildings, etc., must be filed with this application). � FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED 8Y----------.---.-��~�~.�~��--- ---------------------------------------------------- D/\TE---.-'- 1~~ —.------.. REVIEWED BY-----------------------------------�---'_��/-',—''~a—^ ------------------------------------------ DATE__._`-------- BUILDING PERMIT ISSUED------------------------------------------------------------ --------------------------------------- DATE-----',-_--_---______.__- � Altan,tiwnsmn6/o, pocommmnn6utivno:—.--__.--__---___-------.-----.------_________________-._________.____. | ___-__--_---_-__—__-.__--__-_'___-__—_-_—_-__.___--..__---__—..___—___--__----__—. '—'--'--'—'----'---'--''----_---'---'-----------''-------'''---''---'—''-------------_—__-z-- � ___.—_.—'___''__.'__—'__.'-__—'-__-'----'--_,—__--_'_—____---__--_—_--_-.__..___--_- ` ------------'---------'``-------``------'`��------'`--- ----``------'--``------' -------------------- ---------------------------- ------------------------- ------'`---` PERM[TNo—�. ./�-------- ISSUED--------/- �� '.�� —__(D=fn) FINAL INSPECTION 8Y -__._ , . Date---------------------- _—'--'-------- SAN JOAQU)N LOCAL H64[[H DISTRICT � 730 South American Street Stockton, California " ES-9-2M 9'50 vv~ia»v