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O OFFICE JSE: _
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<br /> APPLICATION FOR SANITATION PERMIT
<br /> (C:errlpla+e�1 Dapfieh�
<br /> oah Issued .,9.�d. .tC'
<br /> _. . This Qemif bakes 1 Y� Freas Detel�d '
<br /> Application is 4m by mode to the Sen Joaquin Local Health District for a permit to construct and install the work lwrein descnbwd: ,
<br /> This appl'Katioi is made in compliance with County 0
<br /> inane No.S4
<br /> Vol
<br /> t
<br /> JOd ADDRESS Alf TION. .,
<br /> Owners Nems. �..�I1.. Acr
<br /> + ;
<br /> Contractors Nams.... «.. :..,` ..�....w..........w....».«.. Phone..
<br /> —4.
<br /> t
<br /> r; Irutellation will serve: Residence Apwfw4 et d Cr:rrwrle". 13 `rmilar Court Q Motel Q 'tt
<br /> Number of living units. .. Number of bwdrooms X..,&NrNtiil�oF baths.r Loft>wsa. � � °
<br /> i wuM�r Supply: T Public system �Cit�►sytenlPrhrit� Q Depth;to.Watw Table I **• '
<br /> Cltaweter of on to a depth of 3 feat- Sand Q ;Gr'ew C� C*Lown C7 Gel►O Adobe i�'�
<br /> ` Application Made: (if yes,*te......... ....:�1 ,Nark!' Nw«Ceifelnre,•tet:'1'es Q No 90, i,, � At Yea Q SNC{ a
<br /> �F INSfALLATION AND SPEddIFICJI f n r
<br /> (No septic tank or cesspool penrriltedPA
<br /> 'c Task: Distance from nearest` ... Maw... ......
<br /> »•' "/ .. No. of compartments». ...�,,.....,Capatiti►�
<br /> ,Jls dv : Distance from"arost
<br /> Number of Wirer-ryfb(roes...«...«..�»«�a....:.�..w'rr .. f.. '�' WW*Wr�rCl1...... r"'° „y'"� ,
<br /> � c
<br /> Type of filter
<br /> r `
<br /> Seepage Pit: ! Distance to nearest well...,, i±aerest lot
<br /> ',"Now �', % � ;
<br /> Number of pih .
<br /> C�SsPodJ1' 1 Distance ft&h nearest
<br /> Size: Diameter......«.... K
<br /> ��Privy� j Distance from nearest
<br /> t: Q .t'; Dlstenw fo neiwst lot 1'irro'
<br /> � it •a i .pt.,. ,w r..+�; ..£� � „s rt Ar"; j 43
<br /> xa Rt►ntodelirt aril/or repairing (descnbe)% ,i..�,,..
<br /> .' ,.dlyry..... ...... ..w n.ix.n....... w....+....�++r.�»... .........«.w`.w.w.. r ws.:.w.t..w++......
<br /> I«herebti cop*that I haw prepared this appliea411a'errrlklhiiM ihaj�iretfi`wi�bei dare liraaeerdarlea WK Ss►
<br /> e .Jea14ulrs
<br /> a� ei lliMnas, Statelaws. and roles and of flw`SMr Joe ii►L blrl FflNlltfl ar �F �a: ,.
<br /> s£3 �.... ........i..-S .........
<br /> ,ce^+ ��
<br /> ................1.....1.........................»....«...
<br /> i `rplot plan,showing size of lat.location of system in relesr► abstlldir a bIM1 brt,pllked ertrwerye idd��.: , .
<br /> r�RDEPARiMENT,USE:ONLY, .� ,
<br /> iI1rpPUCATION ACCEPTED BY....... &
<br /> PREVIEWED BY.................................. ..� � . .4 .�.. DA
<br /> �Ui DING PERMIT ISSUED............. ............ . ,.,«..�;, DATE.,�i.....»......�.w..........
<br /> ' AlHratl and/ r� ���
<br /> .
<br /> ..• .............................................................
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<br /> i uiMii.i YN4.4irMwM.X .w.i.w+.YwlMw...NW.w+r#rF+.�.w..a.wNwL.ww. "S.OfMa�
<br /> ...«................................................................ NnOi..w..Mid�'
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<br /> .... ............................................................................... ...i 4wMWi Vi..aMiYNM1 Mwh.w 1« ..�.wiW.3 i«K.JLiw
<br /> •' t�a�C•„fit+,° �t ,"1 p S ti.. n ,y �.b,} � �; ,� i, ,F
<br /> l - F.3 ✓'r. Sp'a'.'z yy ..^.c¢ 'ar�i 4 Y `�S'. M
<br /> j .FINAL INSPECTION BY:......
<br /> SAN JOAQUI `LOt:A4�1E�►1.'f N
<br /> ri 1.01 1.H"Often:I9. 30 WrM OrkVxrF tp .,yes+liver tia�ln..t .,
<br /> lel't�phrllra
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<br /> ry05 r thelq C�phlrMi
<br /> fNlItN11 �IIrM11N - w 41l?s'.'f 1.y+� J
<br /> s'Ys
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