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(Q APPLICATION FOR NITATION PERMIT Permit No. ..., / r4_fi. <br /> \ (Complete in Duplicate) �0 / <br /> Date Issued ____ 1 _ <br /> Application 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. <br /> JOB ADDRESS AND LOCATION..... __ 1.--__ ------on... est--side•-_cf__Alpane__Rd,_,_--8tk' ne <br /> Owner's Name-_---------Wm*___-8I1d•_Donna Johnson Phone Hol ,� 0802 <br /> - ------------------------ -------------- ---•--- --- ----------- <br /> --• <br /> OX --80Stk! 1.Address•-•------ ------ ---B - :--- • -- <br /> Contractor's Name De...��A Phone-. ©`•- "���`T-•-- <br /> Installation will serve: Residence ® Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: __-__ Number of bedrooms ___�__ Number of baths .z____ Lot size ________-_-_l - ----� <br /> 3- •___________________________ <br /> Water Supply: Public system ❑ Community system ❑ Private ® Depth to Water Table -_45 ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe[a Hardpan ❑ <br /> Previous Application Ir7": Yes Uj No ❑ New Construction: Yes ® No ❑ FHA/VA: Yes ❑ No [it <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> _ .- . ___ _ f a>e 1 e a®went (rourn►d) <br /> Septic Tank: Distance from nearest well--50-1. .-_.Distanc from oundation____..__ M erial__________ _ _ _______ <br /> Xx:k No. of compartments__-____-_-2____ _ ___Size_ �p &_____zp_.__-Liquid depth_.. ___ __. Capacity 40-._-____• <br /> Disposal Field: Distance from nearest well --_-5Q!__-_Distance from foundation---SAP16_-Distance to nearest lot line..... f? .. <br /> Ek Number of lines-----------1----------------------Length of each line-------40 <br />