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FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMI Permit No. <br /> gplication is hereby made to the San Joaquin Local Health Dist rict for a permit to construct and lnst�ll the work herein described. <br /> Is ith County Ordinance No. 549. <br /> application is made in c li n9qwi <br /> JOB ADDRESS AND L0CATlON.&4ttd.1/1.Ay/___14 ------4--- <br /> Contractor's Name............. a......_AZr,4,.,4Z...,----- ----------------------------------- Phone) <br /> Installation will serve: Residence g3--*`Xpartment House EL'Commercial TEqlle Court E] Motel 0 Other CI <br /> Number of living units: ber of Lot size ------------------ <br /> _/--- Number of bedrooms A� Num b fD <br /> Water Supply: Public system 991--community system El Private [] Depth to Water TableA6_0_ ft. <br /> Character of soil to a depth of 3 feet: Sand E] Gravel 0 Sandy Loam [-I Clay Loam P".6ay C1 Adobe 0 Hardpan C1 <br /> Previous Application Made: (if yes,date----------_-------- No [:] Now Construction: Yes (Er"No [:] FHA/VA. Yes 2? <br /> TYPE OF INSTALLATION AND'SPiCIFICATIONS: <br /> (No septic tank or cesspool p;rmitted if public sewer-is available within 200 feet.) <br /> Sep;;&nk: Distance from nearest we,710tv- ..Distance from foundation---,�1.4��--'---.�Aaferial--��----66_/�..... <br /> ---------------capacity... ?e. i <br /> Disposal ield: Distance from near st Distance from'foundation-.,/Al 2.........Distance to nearest lot line............ <br /> )f lines-_-3/-------- <br /> Seepage,Pif: Distance to nearest well----------------------Distance from foundation---------------.—Distance to nearest lot line................. <br /> -------------------------------------------------------------------------------------------------------------------------------------- <br /> ` <br /> ---____ -------------------.-------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------ <br /> � <br /> . herebycertify - �� 6 th thowmr *D be done acmmr6anme * � Swn Coun+y � <br /> - <br /> ,4"nd-reg s.o the San-Jo quin Local Health District. <br /> (Plot pa'' showing ~^~ of ~' _--.ion_ �,'',- <br /> fe;Oln relation to wells,buildings,�etc.. can be placed on reverse side). � <br /> FOR DEPARTMENT USE ONLY <br /> xtv|Evvua BY----:',' ..__.—_-_--'�t���-'----------------------^'— ~' '`--'--'-----''-'----'-'-' <br /> / ; DATE BUILDING PERMIT ISSUED___'--_--_.'_-'---'_-'_''__.-�`--.''-'''-,__ '-'-`_---'-'''-'-'----------- <br /> Alterationsm :-------------- -------------------------------- ------------------------- ............................................ ......... -------------------------- <br /> .................. ..............------ ----------------------------------------- --------------- -'-r'----'--'------'----------------------------------------------------------------- <br /> ' <br /> -- ~~- ''-_''_-'-----'-'''--'-''_''-'-'''-''-'''-'''�-'---'---'�-_-,-_---'-'-'-''-'--''__.-_.-'-' <br />| v - " � _____^'---'_--_'--'-_'-''-'- � <br /> -- /'_`--_'-'_.------_''-'''---''---''--'_--'-_-'--'''-_''-'- <br />! ' _�______________/________________�__________�_--'-'-''-''i'--'''-''_---�-'-'-'-'---'-'^'--' <br /> - <br /> ^� 2_ <br /> FINAL |N6PB�T{}N 8Y�� ------. Du+a'--),.. -��-�.��-------__- <br /> / - <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT ^ <br /> �130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> �"�*" California �u California ` m"m�oCon��� . Tracy,California <br /> ` ^ . . <br /> "" p pu""m o*° nm °'"/ ^*^" <br /> ��� <br />