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FOR OFFICE USE <br /> ----------------- <br /> iApplication is hereb made tc0-he San Joaquin Local Health District for a permit to const uct and install the work herein described. <br /> JOB ADDRESS ANNa LO <br /> ----------------------------------------------------------------- <br /> ' This application is made in'compliance with Coun�y Ordinance No. 549. <br /> Contractor's Name �... <br /> ..�- <br /> Installation will serve: Residence Apartment House Commercial I0 Trailer Court C] Motel 0 Other 0 <br /> Number of living units: Number of bedroo <br /> Water <br /> ublic <br /> Supply: —I <br /> soil -'-- =^ ~~�^^~^',' np'6"' nm LJ Depth to Water Table 57P ft <br /> Character of o� to m depth of feet: 'Sand G3nn6v Loom�[] Clay Loam [] Clav [] /dabe=`-~��mn�mon E]Previous. <br /> Previous Application Made: (|f yox,dor�-'---.-) No ` New - Yes [] No -- No <br /> Yes <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: 1 11 <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> i foundation <br /> N of - '---'' "Material^' <br /> ODisposal R d: ^ �----° --Distance -from '-^'~a' trench <br /> -Number o+ |�o� ~ ~ ~�p"' °' ""=, mornnm <br /> /���� - <br /> l <br /> Seepage Distance to neareston <br /> Nurhb�i of <br /> - ' ' . m IV ` <br /> Distance from nearest well----------_-----Distance from foundation Lining maf,"'rial------------------------- <br /> _'__--_'._-'-�...- <br /> 4! ...........-_-_.--'_-_-_-__.-__- 'Remodeling and/or' re'pairin -(descri <br /> - =�~.- ^~�_ <br /> -__'-_--_-. '/�-��.._--'---'_-_.._____-.-__- --------------------------------, �__'-_._-_'------'----_--'---�'--- <br />� ------------------------------_�_.��-_�^-------__-__--__-._---_____ +x . � -'_-----_-.-__-'-_--_- <br /> -. <br /> -.1 have prepared this application and that +he woA will, <br />` <br /> ordinances, ocal Heath - <br />| <br /> (Signed).... - -- --- ---------- ----------- ---------------------4-_Yner and/or Contractor) <br /> 7................. <br /> --------------------- <br /> (Plot plan.— showing size. of lot_ location o' °r"=m n relation to s, buildings, etc.! can be placed on reverse side). <br /> FOR DEPARTMENT USE ON <br /> ArruCA//um ACCEPTED BY- � ' <br /> T T <br /> ---------------------------------------------------------------------- <br /> DA E <br /> BUILDING PERMIT .^^"E°--------------------------------------------------------------- ' DATE �����—' <br /> Alterations and/or recommendations: I le. ....... <br /> _ '' -_--- -'~-'---_''-'_---'_-'--__.-_'_--._-._--- � <br /> --'-_''-'--'''--''-'-_ ----'--'-_--- '------------­------------- ''-_'''-'---'''----'--_.'-'--_. <br /> ' . <br /> -.--_----------._--_. -._--_---_.-----_--'-_ <br /> '''--'----'_-'''--'---'-'''-'_--'-'-'--'-----. � <br /> FINAL INSPECTION BY:_._. Du��---..���`'_ ^��.��..�� ~� '-'--'^-'_ <br /> AN JOeQW|MLOCAL HEALTH DISTRICT <br /> 130 South American Street 3woWest Oak Street 1x«Sycamore utree, n0uWest 9th Street 4 <br /> ~.oc~~.'^~,,orri.~ Lodi,California Manteca,California rran'.California ' <br /> v REVISED "'a° ww 5'e1 m`^° � <br /> ' <br />