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t <br /> APPLICATION FOR SANITATION PERMIT <br /> ... <br /> Permit 140,22 <br /> ttCeAMiNe In TrysltceNot .. ' G <br /> k/) <br /> ..... .:,: ...................... � *A Past � Year �nais Qrrte Date issued :�:.�--t-2� <br /> is hersby made to the Son Joaquin Loans Health District for a permit to construct and install the work herein <br /> . This application Is made in compliance with County Ordinance No. 549 and existing Rugs and Regulations <br /> *8 ADDRESS/LOCATION .l�r.� :.... : .......,..C'EN3t TRACT .. ............««..,. <br /> Owner's Name <br /> Phone 'l.?w <br /> Address -- • ! .... . ......,.... ..city .. ... .. <br /> Contractor's Name ., ...sezKt.. .... . .. ....... ..............Licaense . Phone .. ..... ... <br /> .. . ....... .. ... .... <br /> Installation will serves It"idsnce p Apartmw*raise Commercial"Trailer-Court 13 <br /> r....... <br /> Number of living unites. Number of bedroom: Grinder Lot Sits <br /> Water Supply: Public System and name <br /> .. ... . ....«:. .. .... . ..... .Prtwrte <br /> Character of still to a depth.of 3€sett Sand'[3 Sib❑ Clay-0 Peat❑ Sandy..Lam['"Clay Loam 0 <br /> Hardpan 0 Awe 0 Fill M6terial............if yes,type. ........... <br /> (Plot pkcn, showing site of lot, location of system in relation to woos, buildings, etc. mit b+rr <br /> placed on reverse SI& <br /> NSM OMALLAT10% lNo septic tank or soo a{aIt perm tMd If public mw is available within:alp 4680 <br /> PACICAGE TREATMENT I ] SEPTIC TANK;7 Siete.. .. ......... . � i : <br /> 4 Capacity .,?0V. . . T1rps� P-'4 ,- vial . No. CompaKbrients «�-„.«.»« <br /> Distance to newosts Well . .A Q .............Pour tion-449 Prop. Line»,. ...»«,. <br /> LEAI*NG LINE IO <br /> C No. of lines ... ../ ......... . Length of eactine---At .2a. Tarot Le v* «. <br /> ©. Boxo. h. . Type filter /Nltderlof C!l�r.! ! !t?p th Fitter Material >.`Y., <br /> Distance to nearest, VWII ....Z rl s�.:.....wFoun�dotion ....1 . �operty Line .......»«..... <br /> .... ...... <br /> SEEPAGE PIT [ I De Nurnber <br /> .. _ R«k fdbd Yes E3 �! <br /> Water Tablet Depth .... .. ...............................Rock Sita ...« <br /> Edi:tan+cro►to neae+,Wall' ..... « .Foundation .«« .......« Lina` <br /> Prop. .................;..,. <br /> MffN ADDIRIGNlltcrwr. Sanitation Permit ............................................ Daps :..«..«..«....«.............. <br /> Septic (Specify . <br /> Tank Requirsmer+ts} .. ...... .. ... . <br /> Disposal Meld iSparify Requireiviento -.� .. ..... ............ .............»....... <br /> ............«:.. .«..«.....«. <br /> . ...... . ................................................. .....:.. ,.;...... ...:..... ..:.... ......... t,.««.«..«....rue. .««. <br /> A, , <br /> ..............................................................Draw existing and required addition. ««:.,: . ... - .«.............. <br /> on <br /> I ,41isrft that 1 have p dds appucagoa a” that the wreck will be,done M eaoardeaso w0b !bole <br /> County OW104 ees, Stam taws, and Rules and 11"w Reas of dw San Joaquin LOW Head*i�sMd.Heane eaa40 er ll6"W'w' <br /> sed 09"ts s onahnrti(eel "iM f+etiewhgs <br /> ••! sertifr *at is- mace of dw worts fw wldelt ak Isamu is issued, i d" 469-Stapley my per$"In so& <br /> as to beaor to workrNrerl't; �aRfera <br /> Sined i <br /> .......... .. ...... .. .. ........ ..... «.Owner <br /> if other ................................ ?itle ............................ ... ... <br /> t than owrwY <br /> dQ AN ARTSA T Usti ONLY <br /> Z <br /> APPLICATION ACCEPTED BY .....:.. ......... ............................. ........:........... DATta . ...,...: ..... ....�.r. «..« <br /> BWLDING PERMIT ISWED .... ......... .. <br /> ......... ..........!......... ..... .:. ........ ..:...... .......::.,..........DATE.........:. ....«.... ..... :.:... ...;.. <br /> ADDITIONALCOMMENTS .........................: ,,...:,. .......... ............. .., ........... ........ . .................. ..,...... ....................»...... <br /> Finalby �. � .. 1:7**"»y. ... <br /> Inspection by. . w., . . . ,..................... «.... .Dots. �' :7 <br /> SAN JOAQM. LOCAL HEALTH DISTRICT <br /> C13 24 t--Aa jm... seri +� <br />