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` . <br /> APPLICATION FOR SANITATION PERMIT Permit No ...................... <br /> ~'-'r-�� | <br /> � ~ <br /> `--'r-- --'--' <br /> 7 )| Date Issued <br /> q� / <br /> � <br /> Applica4iori is eny6v made to the San Joaquin Local Hoo|H` District for u permit fnconstrmc and install the work herein described. <br /> This application is made in compliance with County Ordinance N <br /> JOB ADDRESS AND LOCATION.. X7 oe 1W <br /> ------------------- <br /> Installation will serve. Resicl6nce 1��Apartmenf House E] Commercial [] Trailer Court Motel Other 0. <br /> Number of living units: _/--- Number of bedrooms S. Number of baths Lot size "----------------------- <br /> Water Supply: Public system E] Community system [] Private �Depth to Water Table ft. <br /> Characler of soil to a depth of 3 feet: Sand 0 Gravel E] Sandy Loom E] Clay Loam E] Clay E] Adobe gl--Hardpan 0 <br /> Previous Application Made. Yes E] No ??-'New Construction: Yes [] No?3- <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if pu6lic sewer is available within 200 feet.) <br /> Dis o Field: D�stance from nearest well-- -.-.-Distance from foundation--- ----- ----Distance to nearest lot line... <br /> Type of filter mafe �a;---/t__*4kA-�.Depfh of filter material------Af. ..... <br /> le .'% I - -- ---- --- <br /> Remodeling and/or repairing (dr ---------/-4 -r, <br /> )__4 <br /> --------------- <br /> -------------- -------- 7�0 _ -I <br /> ------------------------------------------------------------------------ <br /> *---------- .VZ <br /> I hereby certify that I have prepared this a��li�ation and that the w6rk-will be�done-inaccordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of fh� San Jo,iq�in Local Health District. <br /> (Plot plan, showing size of lot, location stem in relation wells, buildings, etc.. can be placed on reverse e). <br /> FOR DEPARTMENT USE ONLY <br />� <br /> ' <br /> REVIEWED BY------------------- -' ' ��� �� <br /> BUILDING PERMIT ISSUED-------- D/g�__Z`T�___________________ <br /> Alterm+|unu and/or recommendations ------ -------------------------------------------------------------------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------------------------- ------------------------------------------------------------- ------ -------------------- --------............ <br /> . , <br /> ---------------------------------'''-''---''--''-''—'--'---r''- ---------------------------------------------------------------------------------------------------------------- <br /> ---------------------------------------- .---''--_''''-'''-''--''-''''--''--_.-'_''''-_'''_---'-_'-----'-'-_.-- <br /> ____________�_�____ _______________________________'___________ ___________ <br /> lqN/\L |NSPECTC)N� BY:.-- .---------` ^ [���--'�'���-.]'���'--.-.--.--_._--- <br /> � SAN JCJAQU|N LOCAC HEALTH`CU '' <br /> ^ <br /> /m South America" Street 300 West Oak stroet mo Sycamore Street 814 North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy. California { <br /> ~ <br /> "5-9-2m 14544 =^="" 22-54 i <br />