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� t <br /> FOR OFFI�_E USE: <br /> ' . . - ^ . <br /> -��» � - y� ���� '��j� ���� ������� Pm,m� N� <br /> ' ' ' � 0u �u�»mmv� �wtm �oum� <br /> ~ <br /> This Permit Expires I Year From Date Issued <br /> Aon||cuMon is 6wrm6v made to the Sun Joaquin Local Hna|fk District for u permit to construct and 'install the work herein described. <br /> This application is made in compliance with County OrdinancS�40. 549 <br /> ............................................ .................. ...................... <br /> JOB ADDRESS AZ, OCATION--- --- - - ---- - ----------- ---- .................. <br /> �� 7 <br /> Add - <br /> ----------------------------- Phone <br /> . � -- <br /> Contractor's N - <br /> Installation �rcial E] Trailer Court [] Motel Other [I <br /> - 'ill- serve:_ Residence ~~ . -- � <br /> Number of living units- Number of be6noom, =w _Num6�, of 6a+6o _ Lot size <br /> � � t\ <br /> « <br /> ----- <br /> Water Supply: Public uy,ham � �ommunMy system El Private Depth toWater To�e4/ t <br /> Character of soil to m depth of feet: Sand [] Gravel `--- San6vLoum [] C�vLoum [ Clay Adobe ----.-n--- <br /> l <br /> Previous Made: Ufyes,6ot�------) No [] New' Construction: yea `No �- r "~ Yen [] No [] <br /> � <br /> TYP� |�� �N���LL��|��N ��N� �PG�|���J|��N�: ^ <br /> (N �� tank or cesspool permitted ifpmb���r is �mi�b���n 200 feet.) <br /> Distance from nearest well-----------------Distance from foundation---------__kJota,iuL-.-'--------------.......................... ` <br /> No. of compartments------------- -----------Size....---------'t-----------_Liquid 6op!h--------------------------Capacity....................... \ <br /> Fo � D|�mnco �om nmano,+ *eU-----_Di�unc� fnom.found�Hon---'---..Didnnco,�o nearest �tUnm....-_'--- � <br /> Length �� 6` S �6� uf ��n� <br /> Number au no_____..__._ ----------------------------------- <br /> Da�� of �K� material '��m| �no�. ` <br /> Type v" ""�, �"= o4 <br /> 3ao /t� DiNumber <br /> to nearest o..�xxmucAy�-.umnucn , noa"""'�^- -- .��to ..~...^. lot <br /> ~---.--' � <br /> Num6�, c� p|fo-. ^�----.Uning material -S|ze� D|om�toc-����.--.-Depth-..07��-�.-----' Ci <br /> Distance from nn�r�� �oL °'--'-D|dn ' from foun6uHon---_--Unl mote��_—._-_--,-__ `~ i <br /> Cesspool:° - Dmo�6 Uow|6 �upmc�� �uu� �J / <br /> [] Size: D�metec----.---�—_ , ____-_______.___ . . . _____..___._~~ <br /> P�vy: Distance from nu*no� v=K'''�-�------------------------------------Distance from nearest building'-'--------_._-'_ _ <br /> [] Distance *znearest lot line-----..�--------------------- _.-__.._____ --------------------------------------------- _____. <br /> Komo6oing and/or repairing (describe):--------------------- ---------------------------------------------------------------------------_-_- .........................------ <br /> - <br /> __..--------------------------------------------------- ------------------------------------------------------------------------ ------------------------------------ <br /> �----------------------------------------------- <br /> '—'----------'---'---'----''-------'-----'-----------''---------------'--'-''----- <br /> --'-----~—'--'----------- -----'--'-----------'-------`--------' <br />� --------'----- have prepared +his application andthithe k will6 done 3uaccordance with San Joaquin County <br /> ordinances, nor and/or Contractor) <br /> em wn� rm�u�nonp n` rn� San °o"q~." ""^a. Health District. <br /> , ' [ <br /> ''--'--'''' <br />. (Plot plan, showing size of lot, �cwfloo of system ,n*�/wnon to =e"^, buildings, ".�,. ^.. ~~ r..-.- _ reverse� -__r <br /> //-folk DEPARTMENT USE ONLY <br /> nEv/E~cu n/-------------------------------- - -.----'---'--'-'-''---'-''-_''-_.-�---- I ° <br />. and/or ,._-----.`--.-.__-'___.��_---_---�..-�-._----__-__--_--_ <br />` -_---.__-------_-.--_- � <br />^ -_--------------------------------------------------------------------------------------------------''''__---''_----_.---_.-'__._--',-_-'''-'--_-'--- <br />� -' --'-'-''--'--''_—'-''-----.''-_�-�--'--���'�''__.---'---'^'--'-' ' <br /> __-'-'—''-'-''-'--'_-'- '-------------­- ''—''-'''-''--'''--''-'-''-''-''---�'-�--'-''-'-'-''---'-- <br /> --''-'-'---'------' <br />( <br />> <br /> FINAL INSPECTION 8Y� ---------- <br /> SAN <br /> '-- Dofn-''����'��i^�x�����x --'-------__' <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT ` <br /> 130South American Street 300 West Oak Street 1owSycamore Street 205 West 9th Street <br /> nm"m"o California Lodi,California Manteca,California Tracy,California <br /> ES REVISED o'"° "w 5-61 ATLAS <br /> � '` . <br />