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FFICE USE: <br /> -- -------------- APPLICATION FOR SANITATION PERMIT <br /> This Permit Expires 1 Year From Date Issued <br /> A�pjicafion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> application is made in complionce wi .0 <br /> 49,A/o--_-----_----_--............................ <br /> Addram-----------------P. <br /> Instagaflon will serve: Residence Er Apartment House [I Commercial [] Trailer Court (3 Motel [3 Other 11 <br /> Number of living units: A---- Number of bedrooms --3. Number of baths 0- Lot size ./ _XLao--------------------------- <br /> Water Supply: Public system 2ye"C-ommunity system F-1 Private [] Depth To Water Table 13- ft. <br /> Character of Soil to a depth of 3 feet: Sand ��Gravel C] Sandy Loam[I Clay Loam 0 Clay [] Adobe[3 Hardpan 0 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.)7 <br /> Se k Distance 'from nearest wellMNR�_Distance from foundat .........Material yqj;;�KF <br /> Disposal Field: Distance from. nearest weli_NVNJE�.Distance from foundai 4.- IC7 <br /> . _� <br /> Remodeling and/or repairing (describe):-._-_----__.--_..____.-__-..---___'--__.----_--.____-___--_-_ L�� <br /> -_ . r -__. - -- - - - ______ --- __._______ - - - -- _ <br /> . <br /> - -- -- - - - ---- - - -- --- - - - --- -- - -- - -- -- -- - <br /> �����`'����`�������������`��������'���- -`- -- ---- - ��- -'-- - - '- <br /> ----------------''----'--� nJ ��� San Counfy <br /> ------' 6 X �m�� �,mpmmo� t�� appU�mf�nan6 +�af +�* ��,k�8 6� 6mneinmccomm�w ��m�u/n <br /> ' ~~~~yc�'~' ' —ordinances, State I ws. and rules and regulations pf the San Joaquin Local Health District. � <br /> ��|nm6�--- '�' '----_.=-_-."-�--.^_-.`.�--,--.- nor and/or-Cou�m�o, ~~ - <br /> ` --__.-_-_.—__-'__--______-_' ". -------------------------------- <br /> � ���� 1� ��� ����. v�~ �� k� placed� on mvm� side]. <br /> 8��� plan. showing size of lot. location of system <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED 8Y--.�-���'°��'"-----------------''------'--' ~'^^'--'vr'-------------- <br /> ! E D/� ------'---------'----'— <br /> REVIEWED8Y_.___-.__._._-'-----__-_--_---`---'--'''--'----' <br /> BUILDINGPERMIT ISSUED--------------------------------------------------------------_...................................... °A.E_-------------------------------------------------------- <br /> --- ___ <br /> ' --__' and/or <br /> -- _ - <br /> ��. '---'''-'--'--'---'--- <br /> -e -_� __�'�._--_ � � . Y __ <br /> -..__-_-_~ - ------'-----------''---''-----'----------'---'' <br /> ��-'''- -----'----'----'--'-------------------------------------- <br /> Date <br /> ------- <br /> u <br /> Du��-.- � .—.---_-_'_- <br /> �-. -' NAL INS <br /> ' <br /> LOCAL ffEALTHD�TR��T <br /> ��� �����l� <br /> 130:outti American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street , <br /> �=x California �m"�"�mmm�"� r��'«�/n�"� <br /> um:m*n'cmo��/� . _ <br /> � - nsvScp amp EM n'an xrLxs '/ <br />