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FOR OFFICE USE � <br /> ° / / <br /> -9 " � ' perm� N� <br /> ����U � <br /> APPLICATION� ����� SANITATION . <br /> in Duplicate) Date |ow^ed <br /> ^ | <br /> Application is hereby made to the 5m Joaquin Local Health District � u permit to construct install mn6 \ns� t6wwo, herein described. ' <br /> This application is made in compliance with County Ordinancp No. 549. <br /> JOB ADDRESS AND I#OCATION�...Iapw-------eAw <br /> Installation W"'ill serve: Residence 2��Apartment House [I Comrhe)rcial E] Trailer Court 0 Motel 0 Other 0 <br /> Number of liv.ing units: Number of bedrooms -?-- Number of baths Lot size -------------------------------- <br /> Water Supply; Public system El Community system 93-4rivate F1 Depth TO Wafer Table A/6� obe gKHardpan <br /> ) No 2j,"*New Construction: Yes Pa- No FHA/VA: Yes gg.,No <br />� <br /> Previous Application <br /> | <br />| <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: | <br /> (No septic tank or cesspool permitted if public oown, is available within" 200 .~~. ' <br /> ro� veW�' "�m. ^���@� <br /> S* Tank: ui�w f �m3~, No. of �� A- � � z <br /> p6 Distance + ^ Distance to nearest lot� .�� ^ <br /> osal F' ' <br /> Number of Un uength of each |mo'JV ---------Width of french. =''-_---_--'-_- <br /> Type of filter materi ;P�&PCDepth of filte <br />�-� �eopu R+� Di�mncn to u/n�n�� . -~~~ _ ___ <br /> Nmmbmr of p�s'��-._-.-Un�g motaru|.����� ri <br /> ��...�ne� umm�,=����^—_--""p.~°_~.—..,=�~,�-_ <br /> "~ � Distance from n�uno� well----------------- from foundation mutor�L'-'-_'--'--___ <br /> ~~-,-- Doo�6 Uou�6 �upoc�� -gu�. \�^ <br />\ [] Size: Di�me+e�-----------.- . -------'------'----- . ' --------- <br /> Privy: Distance from nearest <br />� building <br /> ' I <br /> Remodeling 'n6/or repairing kJosc�6v �'-..-. ~~ --_''' <br /> | --..______-_--'_�____.--_-''-_.'----__-_--_r'--'__.''-_.�_---_'--''--''-'-_-.------'__''- �* <br /> - - .___-__.-'__.-_.-__---_.--_--.-.---.--_.---------.-_------.---_-----.----- <br /> ._---_-_._-- � <br /> -----------------'--''--'----'--'-'----'----------'----'--''--''-'''- <br /> --------'--''---- d that the work will be done in accordance with San Joaquin County <br /> prepared this application <br /> ordinances, State lawLs, and ru[14es �d regulations o�&Ee San Joaquin Local Health District. <br /> (Plot plan. showing size of lot, location of syste re 5fion to wells. buildings, etc., can be placed on reverse side).i <br /> APPLICATION <br /> ` = <br /> -7-- ---- ------------------------- ........ DA ----------- <br /> ' -_--.N_ PERMIT ISSUED---------_--_- -----------------~, <br /> '----'--:---------- <br /> Alterations <br /> � on6/or �.., � <br /> --------------------- ----------------- ------------------------------------------------------------------------ ---------------------------------- ------------------...............................................--' <br /> --___-------_.--_---�--_---_----------_—_-_--_-''_--.__.__---'_.—.__-__--- <br /> , _----- <br /> 44, � �-' <br /> ---- -'—'� 5--''-'--'— <br /> FINAL INSPECTION <br /> - <br /> 'SAN- �� , N . HEALTH DISTRICT <br /> . South American ' + �W��»� 1z4��o� ������ <br /> �ovsw"� <br /> California4w/ California m*^��.mmn��m r��'Cw/��� <br /> mm���° . <br /> so�rRoxocD'a-npcw n-ac «rL^o <br /> � . <br /> � . <br />