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APPLICATION FOR SANITATION PERMIT PermitNu����— <br /> k�mmn�fa in 8upK���� Date |��um� ~� <br /> ` ' <br /> / � l <br /> Ap�| constructon is hereby made to the Son Joaquin Local Hom|+h District for a permit to construct and install the work herein described.Thi' application is made in compliance with County Ordinance No. 549. �Z__,�-O-121D -- u6 <br /> � ^ <br /> honer 1�d-1,143Z_19 <br /> ~~^`' ^ ''ame-- ------- <br /> A66 �� ----- <br /> Installation will serve: Residence, Motel 0 Other El <br /> Apartment House Ej Commercial L] Trailer Court E] <br /> Number of living units: ----V Number of bedrooms ---7--Number of baths ___!�_Lot size <br /> Water Supply: Public system El Community system El Privafe 2�,Depth to Water Table -------- ft. <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam 0 Clay Loam�<Clay [] Adobe E]' Hardpan E] <br /> Previous Application Made: Yes E] No% New Construction: Yes 0 No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> ` (N* seofim tank or cesspool -pe,mN+w6 if public-sewer is available within 200f^eet~'-)~ -�utorio|------------------------- <br /> No. <br /> ����� <br /> 63 <br /> '= = --.- <br /> Sepf|oTank: Distance from nearest U V-.Di,tonco from fovnd tion. /- ..`= <br /> No. of compartments------ ---.. Liquid dapfh.. ��61-----.C°poci+y..2�V---' <br /> cd ku ~~ �^!�'�� <br /> �.1 <br /> D' <br /> Distance fn`� -- Distance ��rumfouno6on-�-�^---�Di�unco tn neu�,+ | � |in* ^ -. <br /> / <br /> -v - -----Length ofouch - V�t of trench of lines i -- -- � ^, ---------------- <br /> Number ' <br /> (�«.|Tvov S�er LDepth of ��er mu+o,nL-' �To�| |enoth-_'-�� ��' _ <br /> from foundation--_.'---_Distance to nearest lot line----------------- <br /> Seepage Pit: D�st ncn t, nearest well--------- <br /> | <br /> � | <br /> Number of pits-- ----------------Lining matnrioL-------Sbe: Diameter--------Depth--.--------.~,Cesspool: Distance from nearest well---------------- Distance from foundation--------------------Lining . <br /> material <br /> -_--_--_--..___--__--______-_.__..--__-__---__.-____--__...____-_.---.--.'-'�-- <br /> --'I hereby certify that I have prepared this lica+ion and that the work will be done in accordance with San Joaquin Cunfy <br /> ordinanceF,-S-fal-e-i S. and rules and 4re , Ialfians of the San�jaquin Local ealth District. <br /> C. _d0br Contractor) <br /> ~r ---'-'--'--------- <br /> e can be p rcedon reverse side). <br /> , plan, showing . <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY------- - --- ---------------- --- - ---- DATE------IJIV-21!�`P/_6�1 F------------------ <br /> AlteruHono =nd/ornm------------------------------------------------------- __.-.____----------------------------------------------------------------------------- <br /> '---------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> --------------------------------------------- <br /> ----''--'''-''------'''--'''-'''—'-'---''-'-'-'''--''---'---''''-''--''---'''--''------''--'' <br /> --------------'--'''--''- ' ' '' ---------------------- ------------------------------------- ------------------------------------------------------------------- <br /> HN/\L INSPECTION BY�------' - Dmte'---'''����^���������--._-___.� <br /> SAN JOAQU|NLOCAL HEALTH DISTRICT <br /> mo South America" Street 300 West Oak street /32 Sycamore Street 814 North "C" Street <br /> Stockton, California u*d/. California Manteca, California T~"'. California <br /> ES-9-2M m°./""J W-z/nn <br />