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-~_ <br /> . � <br /> � APPLICATION FOR SANITATION PERMIT. Permit No <br /> « ` `--`-- - --'---' Date Issued -, <br /> This Permit Expires 1 Year From Date Issued <br /> Application made to the Son Joaquin Local Health District for a per it to construct and | sfall the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. ;7 <br /> JOB ADDRESS AND jOqATION_ //1313 ?.... a_ .. .. .......... ------------------------------------------------------------------------------ <br /> �5n---=---------------------------.................. ------------------------------------------------------------------------ <br /> Address-----------!�147n­ <br /> Contractor's Name---,,C/ <br /> |nstallation will serve. ^Residnnce 2 Apartment House [] Commercial [:] 7raHo, Court [:] Moel [:] Other El <br /> Number of living units: -�-. Number f bedrooms � N u���J��.l(��_~-------------------------------- <br /> � �~~~� <br /> Water Supply: Public system K Community system [] Private E] Depth to Water Table '------- �� <br /> / <br /> C��� � s� � a6�� � 3 ��' Sand El Gravel E] �m� L�m � �� L�m [� Clay El Adob* 19 Hardpan El <br /> ' <br /> Previous Application K4 � Y [� N �M N Construction: Y �� <br /> -- <br /> (No septic tank or cesspool permitted R pu6ticsewervaila'ble' fewid'in-200 et.) <br /> �epfic Tank: Disfance from nearest well---------------- <br /> [7l No. of S ' <br /> Disposal Field: Distance from nearest weU----- ita- rnm 6, --------------------Distance to 'nearest lot line----------------- �* <br /> � of �� . <br /> / nch fermat - - <br /> �- <br /> ..~~.g~ Pit: ~.~.~.^~ .. nearest~ well .. ~ ~..... -�� <br /> Cesspool: Distance from nearest well_&'T.�__ __bistance�f��mro�undafion_/-O------------ Lining <br /> Remodving and/or repairing (describe):---'----------- --------------------------------.,�-__._L__-.___--..�-.____._______'-_ <br /> ---------------------- -------------------------------------------L_-____'----''___'_ _________/___________����___ K <br /> .---'-_-_----''_-_-_.]''-'__-- � '---''L_.-___-_-''' / -------------------------------------- _____________ - <br /> } " <br /> / <br /> ordinances, St�� m� ��s � moS� J� �c �n�nm�� <br /> . Joaquin / <br /> | <br /> . <br /> (Signed) '--- FdR DEPARTMENT USE ONLY <br /> � <br /> (Plot plan, showing size of lot, locafio�of sysfem'in relafion to wells, buildings, etc., can be placed on �everse side). <br /> , <br /> APPLICATION ACCEPTED BY <br /> BUILDING PERMIT ISSUED. - <br /> ��wruMonoand/or rowwmmen6at�no-r---�_+��-' -..__-.__.__-__-_' -._____._____ <br /> ` l <br /> --''-'-'''—''''''-''-''-'-r-''''-`'--''---'--''--------''---''---+-'''--' ''--'----'----'-'-- <br /> ' / � ° ; <br /> -'---'-'-'---''-'----''-'''--''''-'''-------''--'''--''-''''--'''---'--'--'--''-''---''--------- <br /> ----------------------------------------------------- -------------- ------------------------------------------------------ ------ ----------------------------- <br /> ------------------- ---------------------------------------------------------------------------------------------------------------------------- ----------------- <br /> , - ' '�^-'�' <br /> ~`f <br /> -'--'--'-'-'-'_---' <br /> �� \L INSPECTION 8Y'-��� - ----' --���---.� Dut����- --`/- - --------------.- <br /> SANJOAQU|NLOCALHGALTHD|STRCT <br /> . ' 130 so.m American s*°° mm'West Oak s*°" . _ /ox ow w"*h "C" Street <br /> ' sfo"�+on. oaif"rnu Lodi, California ' California Tracy, California <br /> ~ <br /> ES-9-2m n­�=a6-59prCo. / <br />