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FICE <br /> ~ z �v.Z <br /> APPLICATIM.FOR SANITATION PERMIL Permit No. /� ~ <br /> �����|o�m �n �v�|�m�� <br /> ` ' `- Date Issued <br /> -------------- . ' . <br /> ' <br /> Application is hereby made to the 3a ' <br /> This application 'is made in compliance with County Ordinance No. 549. <br /> L <br /> JOB ADDRESS AN CATION. <br /> Contractor's Name_ <br /> Install.ation will serve: Resiclen;�11 Apartm nt House, E] Commercial Trailer Court Ej Motel 0 Other E] <br /> Water Supply: Public system El Community system Private E] Depth to Wafer Table -------- ft. <br /> Character of soil to a depth of 3 feet: Sand El Gravel 0 Sandy Loam [-] Clay Loam E] Clay 171 Mobe U"Hardpan E] <br /> | Previous ',r^~~'^~' ~~~~ ,' ,~~'d~_---- -- No" E3 New C~="`' o"' '"" Ej No mo �� ', <br /> '""/ ,'" '=" " �� <br /> ' TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic fa r-cesspool permitted if public sewer is available within 200 feet.) <br /> � <br /> Distancefrv-m nearest well --''-'Distance fnomfoundu+ion'-'---''-MotnriaL'-''-'''-'-'-'-'�-'- <br /> No. ofcompurtnen�--_----./S��'_---.--._'�qui6 6a�h-----.---Copucih,.--_�-._ <br /> � � � <br /> /^. ^ n-jDistance from foundation-14_1 <br /> '--'---''_—_Distance to ___est lot_ line <br /> �vmhor o+ |�ea �� Lengthof h 6 <br /> Type of filter mut�r UopH, of �|fe, mo+e�� 7ofn| |ong+� ���'~ �~ <br /> '������«�---']- ' ----`r--'' --'------7"^~--'-- �w <br /> Di�nncn fv nou�est ~oU---.-'/_D�tonco fnum. 'ndn�qn_-'-_-_-Di�ancmtu nearest lot |ine._�_-' �w <br /> Number of p;fs''-----Uning material -'''-_��Sbe:'Diumn+oc'''_-'''_Dept k----------------------------------. ��­ <br /> Coeoobl: / Distance 6om nearest well __---Distance from foun6ution-, '----Lining material -----_--__ " <br /> [] ' Size: Diameter -''�--------------------------Dept h---------------------------------------------------- Liquid Capacity----------------------------gals. -V <br /> Privy/ Distance from nearest well--- ---------------------------------------------Distance-from nearest building'-'-'--'---_---'---' <br /> [] Distance +onearest lot Une------------------------------------------------------------------_- ------------ ------------------------------- ------------------------- <br /> U <br /> � ~�~ <br /> Remodeling u=d/q, ,e` �ng k6m � � ' <br /> z � � -� ' __ ___ <br /> ----------------------------------______._______ -l_ <br /> ` ���� _������ �_- ------ <br /> ! ----'--'�--------------''�----'---''--'------------''--'--' --------------------------------------------------------- ----------- <br /> ' <br /> ------------------------------------ ------------------------------- _..z_-_'-__._--_-_.__--.—.--.___.__.-__.___.__.__`----___.^'._._.. , <br /> | hereby certify that I have prepa�ed this application apd that the work will be don i acc n County <br /> ordinances,%Iffe larls. and rules and regulations of the S n Joaquin LoA He ITn ri- <br /> (Signed ... ..... --- ----- ---- ---- - ------ __=onfmc�or) <br /> By:---_.----_-_-- -------------------------------------------------------- -------_------_--� <br /> � �� �n. ��go� � �� �� � �� � ��'. ��� � ��. ,� � �,� � ��� �� <br /> ` ^ .. <br /> - <br /> FOR DEPARTMENT ""= `^"L. <br /> APPLICATION ACCEPTED BY. � -�'-_'''--''-''- DATE'' '---_-''_-^'---- <br /> KEY|EVED 8Y.--__------..!-.-_- _ ---_----'-_._'- DATE-''--''' ---� <br /> BUILDING PERMIT |SSUED'-'---''----- - �-'''--� --''-_-''-'''--'-' ' <br /> ` <br /> D/g�'''-'__�'----'---''------- <br /> Alterations and/or-reoommemda+ions:------------------------------------------------------------------------------------------------------------------------ ----------------------------------- <br /> . <br /> � - -------------------------------- --------------------- ------------------------------- ----- ----------------------------------------------------------------------------------------- -------------------------- <br /> — <br /> . —''--''''—''_---_'-'_''''_''_.-'—''--''-''--''--''-_.'''-_''_-'-''''--.'_-'''''-''_-'_'�--' � <br /> � <br /> —'''-'--'''-'---''--''-_.-'—~'-----''-''-_'''-_-''-'''---'---'-'''-'�''''-'--''--'----�— <br /> - . <br /> ------------------------ <br /> '—.-'----''_.''--''-''--'-----'- ----------------------------------------------- .` �'�'-' -'�''_''''-''_''---- ----------- <br /> - �!' <br /> — .. Date --------------------- <br /> FINAL INSPECTION <br /> W--71 J <br /> ' <br /> N L����L HEALTH D|�T�|�T ` <br /> _ � <br /> 160nE.*""wlo"Ave. 300 West Oak Street `u*Sycamore Street uusWest 9th street <br /> � <br /> : <br /> Stockton,California Lodi,California m""mco''c"omrnia Tracy,California . <br /> "S ° n""M=D °'°° 3M 3-63 ,.F=". � <br /> l <br /> � � <br />