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APPLICATION FOR SANITATI641�11�IT Permit No. <br /> (Complete in Duplicate) Du+n |,m^aJ � ~ <br /> -/--]"'-~-~ <br /> | y\ "e�' made to the San � u| Health District � u permit to construct and install the work herein described.' <br /> � |This � <br /> �� af� is di |� �withCou Ordinance ' <br /> �JOB ADDRESS AND LOWION---------/__ey- ...... --------------------------------------------------------- <br /> Owne _ N�� <br /> Address <br /> --' <br /> ~ ' � <br /> Installation will serve: Residence Apartment House E] Commercial E] Trailer Court 0 Motel [] Other F1 <br /> Number of � <br /> living --- Number-- of bedrooms '~~�' '`~^~~' ~' '~ *-- L"' "^e -------------- <br /> ------------- <br /> Wafer <br /> ''---- | <br /> VVufe, Supply: Public system [j Community system' C1 Private k�pfh +vWafer ` ^� <br /> ' <br /> Character of soil to a depth of 3 feet; Sand <br /> ~ SandySandyLoam ay Loam [] ClayClayE] Adobe pan [] <br /> Previous Application Made: Yes E] No Ek New Construction: Yes mK^o El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> 3 <br /> ~- Difonco from noore`fwe/L_----Distance from foundation-_-----_Mu+e,�aL-.-_-.----- <br /> No. of compartments. -���---Size ''�------'--''Liquid depth -----'Capacity --'- <br /> ^'-r-----.� <br /> , <br /> nearest Distance from �� --d <br /> --Depth of filter material---- Total length-------/_6t_z7ww <br /> � --------Liquid ----_'--------------------------- <br /> Remodeling and/or repairing (describe)---------- <br /> ----------------------------------- <br /> ----'-_'''-__-'''----____--- ----------------------------------- ------------------------------------------------------- <br /> I hereby certify fhaf'l have prepared Ais application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Signed)---------le/w--��--77.--/-!!t5�,;O�117��--"P�41. /- <br /> � -''' ...~/'~ <br /> "y�-_' �m�vmu��---�_-_-_^-_---_--_-.- (T�ei ' <br /> (Plotplan, size of lot, location of system in relation to wells, buildings, etc., oan'be placed' on e'� �6w�'--'-w'-'-' <br /> APPLICATION ACCEPTED BY-.�--`' --''-_-'_-.�'-----'--�' ��TE.'' - <br /> KB/|E\�ED 8Y_ ' -- ' ' �� `�----'',--- <br /> ''--�'�--'----''--'--'''--'''-�'---''---�----'''_-.'-. DATE'-_-_______ <br /> BUILDING PERMIT ISSUED '----'--'—'' <br /> ____-_�__-__--'--'''-^-'_''-^_.--_-''-_'- ux/c'''-'---_-. , <br /> ` Altn,ationmmn6/o, ,wwnmmen6e+ions------- -------------------------------------------------- <br /> --------------------------''--''-'''_-'---.'''-''---''''--'''--_-'''--_-'---''-''--''-_.'-_---_-.__-__-.__' <br /> '_'-----__-`'-_-.__.-_.^-_-.-_-------.---._-_-----__--__--._-__.--___-__._-_- , <br /> '--_.'--_-----''-'''-''-'''''_�''''-''-�`-'''--_'''-_-''-''''''�--''- <br /> ''''-'__.''''-'''--_.''_----- <br /> �-_-'-_'--_'----'---'--''- ''----'�-''''''-''�---''--''----�''--'-�--'--'-_- <br /> ~ <br /> FlNAL INSPECTION BY------------- Date----- <br /> L <br /> ` SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /so s""m American Street mu */es+ Oak Sf,e�e+ /sz Sycamore Street ow w"*k "C" Street <br /> Stockton, California Lodi, California Manteca, California nnn/. California <br /> ES-7-2w 8-5/ na.is"J v/-2100 <br />