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' APPLICATION FOR SANITATION PERMIT ponnK No <br /> ^ .4��C`1 <br /> .5.— <br /> `Como�fo inDuplicate) <br /> i-D6+/o.'|s�"6 <br /> Axplicafion.iis hereby <br /> nm6e to the S�� ~. Local Heo"|+h Mst�ct for a"'-- m� +ocon��ctand ��aU the work 6nr�-,n d'ea,��^/~ <br /> � <br /> ~c~°.| sapplication is made |ncomp|�ncowitKCovn+y Ordinance No. 549 u <br /> � <br /> � <br /> J[)D ADDRESS AND LOCATION___ .---------------------------------------------\ ___'.______.__.______,--__. <br /> [wner's Name- ��� <br /> _ _^"^"�,."___.:i`R.T --------------------------------- ------------------------------------- -- Phone--_--.--_--- ^- <br /> Installation will serve: Residence R/ Apartment House E] Commercial 0 Trailer Court 0 Motel [_1 Othej F-1 <br /> Number of living units: ---I---- Number of bedrooms ----I--- Number of baths ---I---- Lot size -------(0. 1 <br /> Water Supply:-Public system E�/'Communify system F] Private F] Depth to Wafer Table -------- ff. <br /> Character of soil to-a. depth of 3 feet: Sand <br /> E] Gravel -Sandy Loam E] Clay Loam E] Clay (-] Adobe 21/Hardpan <br /> Previous'-Xppl;cation Made: Yes <br /> . E] -- No -- <br /> . TYPE Of INSTALLATION AND SPECIFICATIONS: `w <br /> (No septic tank or'cpsspoo| permitted if 6|iis availablewithin 200�feet.) � <br /> Sunx/ Distance fromn�t n ��y�' o�t t foundation----- _0----------M f ial-----&_Dy0C4*_: <br /> � `c�` � , No. ur cvmpo,nnono--��*=�----..� ������ a��� �i i� d h 'IT�- <br /> Dis | Fibid:' Distance from nearest weU..^s-V------Distance from foundafloR------1(3,---------Distance to nearestiot kne-_ f <br /> french- <br /> Number � <br /> erial-I--- Depth of filter materia------- --------Total <br /> | Distance ) — ` � length - - ��� ` - <br /> *ee�e <br /> �� p�s'''��-��'-Lin�g �u�m,�L Size. Diameter -« Depth---- ----------------------- <br /> Number � <br /> Di,tonco �nm nearestwuL�'----Distance �*m foundation �_'---�ning ma+er�L'-''_' _-'-__-- <br /> - Sn°: Diameter----------..------Dept6----------..,--------.Liquid (�upo6t� ---_-----ga|,, . <br /> Privy: D�f ncofnom nearestwoU---------_--------..Di�ance from 000nzfbuilding------------------- <br /> Distance <br /> --_ ------------------------------- <br /> Remodeling <br /> ''__-- <br /> L� D�| noe +n nearest lot |in°'''_________�________________._____________________________ <br /> Homud��gnnd/or repairing Wez�b��'-,''-'--''�''--'''-__-'-----___- <br /> | �-�'-_-__-__._-____'__-. -.__.___----_- -__--_._--__ <br /> � . * ' .._.-__--__-..__-__--._-___-__-'_.___-' <br /> / _'-''-'-''----''-_.'--^__'-`------.—___--___-..__..___.--_--_�.-�'----_.__-._.--_--.. <br /> ��������__�___�__���_���'_��'__����_����_��_�������__���__���___�_���'_���������' <br /> | hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin <br /> ordinances, State laws, <br /> (Sign��ne6L'- ^ <br /> ' <br /> ed) ' ^�� ------------------------------------------------'-----------'---'—'�`'°"erwnd/ <br /> _/__.____.______..___.__________�________-'_.�-�' /me-------------------------------------------- <br /> -._--'—�--' - <br /> (Plot plan. »hm~�g size of lot, location of system h" ne�f�nto °��, 6�W�g� o+�. can be �m�w6 on reverse �6eL'-�''-'-- � <br />) � — <br />/ . _, ~^. '~~.~~,. ~~^ ~=. <br /> xEv|EvvEu BY. <br /> -'--�'r-----'--�------ -+----_-'----------_-_----__--____^________________ <br /> '--'--'--,'--'''---'''�--'-''!�^�,---�-�__________________��__________________________`_________. <br /> ` <br /> '-''-'----------------------- '�''-'''-'''--�'''-'''''.''�'''_-'--_'_-��'-'''--' <br /> ' ~/ ''-'''-''-'--.'-^_-- <br />| <br /> RNAL INSPECTION 8Y��-' '--.'—'''_------------- Dote --. --_-'-'.__ U <br /> ~ ^° � // ' '--'----' 1 <br /> S/�NJOA��0NL��CALHEALTH DISTRICT- <br /> 300 <br /> USTR � <br /> J <br /> /� s� ��" �� � West Oak Street /32 Sycamore Street 814 North "C" Street l <br /> Stockton, California Lodit, California Manteca, Californi� . , Tracy, California <br /> so--9-2w x=/"°ci 1.57 p.pcn. � <br />