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^ FOR OFFICE USE: Ll / <br /> APPLICAT <br /> ION FOR SANITATION Permit No. <br /> �i � C�n�m�� /7 <br /> [��mp�r� '---^ D��� |smma� __-!� <br /> -2- <br /> This Permit Expires 1 Year From DateUssued <br />----Application is hereby made to the San Joaquin Local HeoHh District for u permit to construct and install the work herein described. <br /> This application is made in' compliance wit County Ord1njPr)ce No S49 <br /> JOB ADDRESS A LOC TION.<2(_A� <br /> I/---------------- ------------------­­...... <br /> Installaflon will serve: Residence gr-Apartment House [] Commercial [3 Trailer Court C] Motel 0 Other E] <br /> Number ofliving units: 4.—,Number4.-,Number ofbedrooms . 4p.. Number of baths LcLoftjza .................................. ' <br /> Water Supply: Public systemB--community system F1 Private [3 Depth TO «� . ^ _bleft. ~ <br /> ��r � � � m ' �1f� �� � Gravel [] �� �m ��mo �� � �� �� � <br /> - ' r ' `-~~� ' __~�� <br /> Previous Application Made: <|fyes 6om,-.-----) Naw Construction: Y�� No [] FHA/VA. You E] No Pa' <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: ., <br /> (No sapfic tank or cesspool permitted if public sewer is available within <br /> Distance from nearest well did. depth___ Z............... <br /> Disposal Field: Distance from'nearest well.... Distance from foundation---- .......Distance to nearest 1of line-.- _....... <br /> Typo of filter me <br /> Seepage � ~ to -' <br /> ��: Distance to n,� u�+u nearest ' <br /> Number ofpNs.......f------------Lining material -Size: Diommta��y;A-----uopth.*�. �-------- <br /> � Di�anco �nom nearest ll foun6o�on-'°--------------Lining mm+er�L---_----_''- <br /> El' Size: Diameter------------ .--'--'_-Dmot --------------------------------- ------------------Liquid ........ ----'-_gals. <br /> Privy-' Distance ^~^ ^~~' ~~'`'''--'''--'--'-'�-''----- '-ro�n -nearest ' ; <br /> .`..~....g and/or .-,-....-, `----_-,'-''-_.'--_-'------ ' ._' � �^ <br /> ---.--__--.__.___----__-.____.-__-__--_.'--___'''-��-�'-'-'_----'-----'------'----'---^ <br />� . . __..---_-.----. <br />/ '--'-----''--'--'—'-------'--'��-�c�---'�--`-�=�-`-''-�--'--'==`=--'r---'-- ~ <br />^ ------- <br /> ------------------- -------------------------------------------- ______ -------------------------- ----------------------- <br /> I <br /> vu�� <br /> �� � n6 +6 �� work will be �m ina��da�e �t San �m u� County <br /> �+~+~ ~ | <br /> ordinances, <br /> s. and rule <br /> and regulations of the San Joaquin Local Health District. <br /> ~v--- ~ <br /> � <br /> (Plot plan, showing size of lot, location of system in r ion to wells, buildings. etc., can be placed on reverse side). <br /> 411 F6R DEPARTMENT USE ONLY <br /> APPLICATIONACCEPTED BY------:-)--------- --- ------------------------­I---­----------------------- DATE.... 2--------W----------------- <br /> ------------- <br /> BUILDING PERMIT ISSUED--- ,?_--------- <br /> _ <br /> -°--L <br /> 'v�--'-'--''---'-----'--''--'--'-'-----'--'-'---''---''--''-'-'''--'-''-''---'''-''--'-'-- � <br /> �\ '----''''--- -''--' ' ----------------------------- _''---'''---''-''-'''. -'---''-''''_''-''-''-'-- <br />' <br />. �� <br /> FiN/�L INSPECTION / .Do+�.���--�^��---'-x�-�~--------'-'' <br /> ` � = <br /> ��\ �/ � "v-JOAQUINHEALTH� . �� <br /> - <br /> 130 South American Street *00 West Oak Street 124 Sycamore Street 205 West 9th Street <br />. ' St=xm" California Lodi,California Manteca,California rra"y,xa/aornia <br /> cs 9 ncwocp ='np cm s'ae xrL^a <br />