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~ '~ "_ ~, ' ° ` <br /> � Permit Np <br /> APPLICATION MR SANITATION PERMIT ' -4-x' � <br />--------------------------------------------------------- � <br /> ��wmp�r� �upn��`� ' ~ . Date |smwy6 <br /> Application is hereby made San Joaquin Local HauH6 District for u permit to constru^i <br /> and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> If <br /> nuu ^ <br /> .~onrmcro,o nom=---'**��"mw�=''��u=�'��'°='------''-----------''-----' -- ' - ' <br /> ----------------- <br /> Installation will nerve: Residence e/\partmmnt House [:1 Commercial [] Tnal|o, Court El MotelOther [] - ` <br /> Number of livingunits:« / Number^ of bedrooms *Z-. Number of baths ~� Lot | u�u�� <br /> Water Supply: Public system irl*,Community system C] Private 0 Depth to Water Table 4KO- ft. <br /> Character of soil to a depth of 3 feet: Sand gravel [] Sandy Loam El Clay Loam E] Clay [3 Adobe U' Hardpan C] <br /> Previous Application Made: (if yes,date------- -------------) No ZK New Construction- Yes E] No Lp�-FHA/VA- Yes 0 No 99--- <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if pubric sewer is available within 200 fee+.) <br /> .ptic Ta <br /> Disposal Field: Distance from nearest well------—-------Distance from foundation.... ........Distance to near ...... <br /> Type of filter material Depth of filter material.. .........../...Tota <br /> Seepage Pit: Distance to nearest well._�-—---------Distance eff,,,nm fo�eation__./ .......Distanqe to nearest lot line-.";% ....... <br /> Number of pits.-'-.1--------------Lining material-_, � Diameter <br /> [] Size: Diameter --.--------------------------»eprn----------------------------------------------------Liquid Capacity----------------:-----------gals. <br /> Privy- Distance.from nearest well-------------------------------------------------Distance from nearest building------------------------------------------ <br /> 0Didunce fp nu�n,st |o+ |ine -----------------------^ ^-..---'—.--� °^ <br /> __...--_----____._'_-_-_-_____-------..__._--__.-__.''--.'-='-_._-_'''-''----�_'-- ���� , <br />� '--�--_--'-__'----_-_'--'--____-''-_'__.__-___---._.. _--_. �-___�-' --' <br /> .........I— 17-----------------------------------L--' <br /> I hereby certify that I have prepared this application 6 thatthe workwill be din accordance w�hSmn Joaquin County <br /> ordinances, State laws, and liel and. regulations of the San Joaquin Local Health District. <br /> -- ' <br /> -------Alt ------------------------------------- <br />� �_-__,-'_�- <br /> (Signed) <br />� By:------------- <br />� of lot, location of sys wells. buildings, etc., can 69 placed on reverse side).lo <br /> FOR DEPARTMENT USE ONLY <br />� <br /> APPLICATION ACCEPTED -.--_-.-----' DATE------------ �'r� =.--- <br /> REVIEWED8Y----------------------------- ���'--''_-'.__----_''_—_--_-_-._---' DATE------------------------------------------------------------ <br /> �� <br /> BUILDING PERMIT u*uEu' <br />/ - <br />/ ^ and/or . ~ <br /> ' -- -___-'-- -------------------- <br /> _---_-_--_. ------------------------------------------—.�^^��_ ------------------------------------------------------------------- ---------------------------------------- --------- _ <br /> ----_------'---_------_-----_------------__--------------_-----__� -----------------------------------------------------___---__-------_� ...... ----------------------------- _-1---------------------- <br />| '---' <br /> h --''-'-'''---' <br /> �L3 = <br /> FINAL INSPECTION __ �`___________ <br /> SAN JOAQVIN LOCAL HEALTH DISTRICT <br /> vowSouth <br /> --��Street � 300 West Oak Stteet � 205 West 9th Street ' <br /> Stockton,California �a�c*o��� ^ ��"�"�n*/wvrnla Tracy,California <br /> "" v =".=" "°. "w °'°. ==° <br /> � <br />