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.Y_ 1 � ✓ � � � •' FOR OFFICE USE <br /> K <br /> FOR OFFICE USE: <br /> - - APPLICATION FOR.SANITATION PERMIT <br /> .............. Permit No.. Ila <br /> (Complete in Triplicate) <br /> .. d <br /> Date Issued <br /> .......................................�..... .........::..... This Permit Expires 1 Year From Date Issued <br /> ApplTcatiori_is hereby made to the San Joaquin Local Health District for a permit.`to construct and install the work herein described.' <br /> This application`is made in compliance with County,Ordinance No. 549 and existing-Rules and Regulations: <br /> JOB'ADDRESS/LOCATION."7 � - -. . -[ ('}KSI TRACT.... <br /> Owns_er' <br /> Name. .VY1_.... ly\ .r` 1�................. .. . --------•--... ....--------- ••--.---..: --Phone q- �.....-- <br /> A <br /> ddress.. [.jC�`C' .? -. Ci <br /> . .� 1 .0 l�<... .. . _... ty X=��' zip... - <br /> .Z-- <br /> . q � <br /> � <br /> License Contractar's`Norne:`V� '-4�f�'v.--Mf- - Phone.- l ri <br /> Installation will serve: Resrd-6 e 'A'partment House 0 Commercial ❑ Trailer Court ❑ <br /> Motel ❑ Other ---------------- <br /> - <br /> ..-._...-... ... I <br /> Sv <br /> Number of living units:_.[t_Number-of bedrooms...-_br. Garbage Grinder-- ...Lot Size. .--.— �- <br /> i - 't , .c' r Private <br /> i Water 5upphy: PublicSysteM and name = . .----- -- ........ .... .. <br /> I' Character of soil to a depth bf 3 feet: -Sand—.0' Sil,E]j Clay*'❑ Peat ElSandy Loam [IClay Loam ❑ j� <br /> Hardpan ❑ Adobe ❑ y;�FiIkNlaterial )_ =1f yes, type------- ----------------- <br /> (Plot plata;showing. size of lat; location,of`systemyin'relati.ori'to�,wells,"buildings, etc. must be placed_ on reverse side.) <br /> x E t - �t 55 M ti /f'- - - <br /> .�T <br /> NEW INSTALLATION. `� (No}septic-tank or, seepage pit permitted if ' ublic sewer is•available within 200 feet,) � �.• <br /> PACKAGE TREATMENT [ ] SEPTIC TANK ize- . .: -�' -��- -.-1------------ ----- Liquid Depth../ --....-'�j <br /> y ._ T e 1 Material... ' 1t7 <br />