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. ' <br /> " ./ <br /> APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) ^ <br /> T�plication is hereby made to He San Joaquin Local Health District for a permit to construct and install the work herein daycr bed <br /> application is made in compliance with Ordinance No. 54/9. <br /> c U A, <br /> JOB ADDRESS A TIC U.-- �. ------------------------ <br /> 0 pae f -- --- ------- -------------3 <br /> Installation will serve: Residence Aparfment House El Commercial E] Trailer Court 0 Motel [] Other 0 <br /> Number of living units: R( Number of bedrooms Z Number of baths I Lot size------- -------------- <br /> Water Supply: Public system E] Communify'sysfem E] Private <br /> Character of soil to a depth of 3 feet: Sand E] Gravel [-] Sandy Loam El Clay Loam 0 Clay El Adobe V/Harclpair�Ej <br />� |ypE OF ImS/ALLa//c/w AND SrEC'r"~n//vnS: <br /> (No septic <br /> 50 1 <br /> Ank: Distance from nearest well C ---Distance fro i4 ---- ------ <br /> 4 <br /> 91� cepth----------- -- -------------- <br />'. El Distance to nean,s+ lot line_ 1 <br /> Seepage Pit: D;stance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line--- ------- <br /> -u mm/o' u/onnn° `rvm nearest .e. �~==' Distance from foundation <br /> -- -- <br /> Depth of �Ha, m���� �.—' <br /> '. of �H�r m�e � <br />� -Remodeling and/orrepairing_— ,e ' � <br /> --------------------------------------------------- <br /> ` <br />. _— —__''—''-----'-- <br />` . ' -- <br />| '' —'''---'''--r'''----------------------------------------------------------- <br /> I <br /> '' '' --- <br />' | <br />! hereby certify that —' ' � <br />� ordinances,= ~.~.~ laws, .. the -_ Joaquin Local_ Health_ --'--L ^ <br /> [Signed)v. <br /> ����.^ �~.=.= a.."~ ~...... <br /> (Plot plans, showing size of lot, location of system in relation to wells, buildings, etc., must be filed with this application). <br /> FOR DEPARTMENT USE ONLY <br /> i BUILDING^ PERMIT ISSUED--------------------------------------- -----� <br />^ <br /> Alterations and/or :---��.�..!���-�—�-- <br /> _—.___--__�—__------____-__------._--__--_-----_-_�_----____'__.._-`���--~_.—. ' <br /> ------------------------------------------------------------------------------------ -------------------------------------------,'''''-''_��—__'''--''''---'''''--_-----' <br /> ._—__--._.____-_--__-_----_..__--_-_—_�----_----_._—''''''--__����—''----------'-'—_.'----. <br /> -'— ^ , ''''''- ���__. <br /> PERW|T N�'�����..��' |3SUED__��..���m` 1�----/-----(]ota) FIN/\L INSPECTION BY: <br /> « � ` Date-----------------���'''/-----'.^---.''--''—'''_—''_- <br /> SAN JC}AQU|N LOCAL HEALTH DISTRICT <br /> |30South American Street <br /> Sfnrk+nn. California <br /> ss--9--2w 9-50 W-1639 � <br />