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- FOR OFFICE USE 0U ' APPLICATION FOR SANITATION PERMIT Permit No. -- (Complete in Duplicate) --------- --------:�� -----------------. Date Issued ._. 2-LFQ $ ,__- .�f fes. "`"'". This Permit 'Expires 1 Year From Date Issued 2S .7 _ 2 '0^ 0 2_ Application is hereby made to the San.JoaquinLocalHealiWDistrict for a permit to construct and install the work here�j� es�fid. ; This application is made in compliancewith County Ordinance No. 549. �5 JOB ADDRESS AND L. CAT�IO --- �-tl _ --K -- = ---- " Phone -------------Owner's Name.- -Q -- Address---------- --------- ox. - 7--5-- -------------IRDPp- --------------•------------------- -----••----:--------------------7--_-p-----•-- -- r . II _ , Contractor's Name--- x_15-� ..... r,_�:.- `��4��+_: C� --•--- Phone-.----------- Installation will serve: Residence Id Apartment House ❑ Commercial ❑ Trailer Cort ❑.wM tel„❑ Other. ❑ Number of living units: _ _ Number;of!bedrooms :5__,.-Number of baths -------- Lot size ----------!CJ_.K- _______________________________ Water Supply: Public system ❑ Community#system ❑ Private 2_1�Qepth to Water Table ft, Character of soil to a depth of 3 feet:{Sanda❑' Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay4'❑ Adobe ❑ Hardpan ❑ Previous Application Made: (if yes,date ) Nox{ „a�New Construction: Yes ®sNo.❑' FHA/VA: Yes-2 No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS- s02 " - - {No septic tank-or cesspool.permitted if public sewer is available within-200.feet.} Septic Tank: Distance from nearest well_ 0-Distance from foundation- ---f -_ --- Mater'raL__ Oflt�Gt l_- -.--.- [ � No. of compartments_._._-". Size-_ z_ - Capacity-Liquid ept -: '_ /0-------- -Distance to nearest line___ ~.-`_i �P pisposal Field: Distance from nearest: ;eIL;_ __�.-.._•,Distance from foundation____ ._ ❑� � -------Length of each line__��"`__<�...Width of trench :-� 2------- !---------- Number of lines---. . -------- of filter material___ 4�'% Depth of filter material___.