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�V <br /> ss APPLICATION FOR SANITATION PERMIT Permit No. .../_/.9�7 J� <br /> i' 11 (Complete in Duplicate) <br /> y This Permit Expires i Year From Date Issued Date issued ...._..L.-. �J <br /> Application is hereby made to the San Joaquin Local Health District foraermit to construct and install th <br /> This application is made in compliance with County Ordinance No. 549. p e work herein described. <br /> JOB ADDRESS ANP LOCATION.. <br /> Owner's Name--- " '-------------------------------- - - --..... Phone.-------------------------------- <br /> --------------------- <br /> Contractor's Name--------- - - ------------- Phone---------------------- <br /> Installation will serve: Residence Apartment House ❑ Commercial [❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: ..__ Number of bedrooms J. Number of baths .9.. Lot size <br /> Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table �•'.Jft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe 01'_H�ardpan ❑ <br /> Previous Application Made: Yes ❑ No 0'' New Construction: Yes ❑ No E•' FHA/VA: Yes 19- No ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> r�(No,septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> 5spti�T n�c:1 Distance from nearest well-.._.___~---__Distance from foundation--...t°�'�-------Materiel.___ �WC _f <br /> p --------Size , <br /> No. of compartments ______ __ r <br /> F r E1 e. �� Liquid depth .— Capacity �� - <br /> {Ts os9l Ver: Distance from nearest well---..7-_...-Distance from foundafion../P----__...Distance to nearest lot line.. <br /> r [9 Number of lines--/---**-- ------ __ Length of each line--� ' <br />