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rUK VrrICt USE: <br /> IA =��� Yom' e <br /> ----- ------------------------------------- ___ --------- APPLICATION FOR SANITATION PERMIT Permit No. .�:C` .� .� <br /> ------------------- -- - - -- <br /> �.J (Complete in Duplicate) <br /> This Permit Ex fres 1 Year From Date Issued Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. / <br /> JOB ADDRESS AND LOCATION._ _ <br /> --------------------- <br /> Owner's Name------ _ __- - ------ ---- - <br /> \ � ----- ---- ------------------------------------------------------ <br /> 13_;&;- ----�-/------- <br /> -------- <br /> #lJ Q__ <br /> _- -- ---- ------- Phone-A7.14-6 <br /> Address-------/—Q.00 <br /> Contractor's Name --- ----------------- --------------- ------ Phone.4 <br /> Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: -------- Number of bedrooms -------- Number of hs -------- Lot size <br /> Water Supply: Public system E] Community system ❑ rivate Depth to Water Table ---. --- ft. <br /> INV- <br /> Character of soil to a depth of f et. San ayel.- a`%Bant �� <br /> Previous Application.la{ad pfdate ___ ) New Construction: Yes No -. <br /> ❑ ❑ FHA/VA: Yes ❑ No ❑ <br /> TYPE OF INSTALLATION AiND�p, <br /> ECdFIC,ATIONS: <br /> (No septic to or ce*poof per+itted if publ' ewer is available within 200 feet.) <br /> Septic Tank: C�istance from nearest well_ -Q_r_Distance from found - n`r/0#0 e7 <br /> ate ial0- . <br /> of compartme ts-----_._ ----------Size___ �,,��`� ��- ------ - --- �� <br /> 7-- x_ quid dept - --------Ca acit <br /> Disposal Field: Distance'from nea st el ` Distance from foundati <br /> Distance to nearest lot/line----- -.L- f— <br /> Numher of lines.__. _._ _t_ ____ Length of each line___ --- -- - _.Width of trencl�:4 <br />