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FOR OFFICE USE: � . <br /> APPLICATION FOR SANITATION PERMIT Permit No. _.,1. - ,� <br /> .--.. . (Complete n Duplicate) <br /> _ . - - ----- CiI <br /> --- Date Issued <br /> 1.- G._. <br />.... .... .... ........... ...... ... .............. This Permit Expires 1 Year From Date Issued <br /> Application is hereby made tQ the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made incompliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION......... ------ •L % --- <br /> --------------------------------------------- <br /> -c <br /> -------------- -•-------•-•----••-•----- <br /> -.,_ <br /> Owner's Name .: Gtr_ Phone.._ <br /> :..................•--- <br /> Address4r-:4:--= <br /> -- --•-•--•-•-- ------•------_•--• •...... . ............•-•-••----..._.... <br /> Contractor's Name----------------- - ' _---_._ Phone......... .._.,................_.. <br /> Installation will serve: Residence ❑ Apartment House ❑ Commercial tj� Trailer Court [I Motel ❑ OthiEr D4�_` <br /> Number of living units: .-/__ Number of bedrooms 2_._ Number of baths , .... Lot size ____ .... .... <br /> Water Supply: Public system [__1 Community system ❑ Privateg Depth to Water Table'--..-:----- <br /> yQ <br /> Character of soil to a depth of 3 feet: Sand F] Gravel E] Sandy Loam [I Clay Clay LoarClay❑ Adobe jR Hardpan❑ <br /> Previous Application Made: (If yes,date--------------------) No ❑ New Construction: Yes LK'No ❑ FHA/VA:Yes ❑ No ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest Distance from foundation...../_Q. Material -- . ..... . ....... <br /> No. of compartments_._.__ t...............Size%%C._'�_ _� <br /> _ _.Liquid depth " ._._ ..._._-•::Capacity.... <br /> Disposal Field: Distance from nearest well----'F......Distance from foundatign......../,: <br />