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FOR OFFICE USE: FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT <br /> ------------------------------I------------ ------ Triplicate) Permit No77..6-70- <br /> (Complete in <br /> --------------- <br /> ----------- - - --------- -- ---- <br /> Date Issued__=�_-_-,, <br /> A <br /> �d <br /> This Permit Expires 1 Year From 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 co lance with County Ordinance No. 549 and existing Rules and Regulations: <br /> ° <br /> �`��"` . .� .. _ �..� ,.�... „ v - <br /> ._ DI7 _ CENSUS TRACT t-� <br /> JOB ADDRESS/LOC TION.__ r;- -,-- t t ��f <br /> , <br /> Owner's Name ----- ------------------ -------- -------- -----_ ------- ... Pone <br /> F ....... <br /> Address ---- ----------- ----------------------r. --- City 1J �fr1f'1- 0.1 Zip-.195 <br /> Contractor's Name --A11e4 O41------- --------- -- License 1#----sek Phone-797r2- r� i <br /> -`' <br /> Installation will serve: Residence [Apartment House.[ Commercial ❑ Trailer Court:❑ , <br /> Motel ❑ Other--I- ------------------ <br /> Number.of living units:...._ ------Number.of.,bedrooms .- `- Garbage Grir�dtr.-------....Lot Size--. ��----- -------- - =----� 6, <br /> Water Supply: Public System and-name------ -----------------------------------------; t '----- = _;-,---------- <br />