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FOR OFFICE USE: - - <br /> ----------------- ------------ -- --- ---------------- <br /> -- . .. ................ . - APPLICATION FOR SANITATION PERMIT Permit No. . r.-.., ., <br /> (Comple+e•in Duplicate) <br /> --------- Date Issued -l�l.�__-_4 $� <br /> ------------ This Permit Expires I.-Year From Date Issued <br /> Application is hereby made to the SS9 Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This appli ti n is adeFCA <br /> mplia a ith Cou Ordinance No. 549. <br /> . } <br /> JOB EAND I - -------- - -xt <br /> Owner's Name----- ------ �!¢�� (M ---•---•-- _ -• --- <br /> - - Phone---------------------•-••........ <br /> -- <br /> Address"L-------IfI`�-F- /-�`'L <br /> ---------- <br /> } C . 1 <br /> Contrackor's Name.. =.. ?-�J ------ one----------------•------------------ <br /> Ph A <br /> Installation will serve: Residence [�Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> r s ., , <br /> Number of living units: __/____ Number of bedrooms:__-- Number f baths_7�LOt size __..3 ---___ <br /> ---- ---------- ------ <br /> Water Supply: Public system El Community system E] Private Depth to Water Table ------ _ ft <br /> Character of soil to a depth of 3 feet- Sand ❑ Gravel ❑ Sandy Loam [/Clay Loam p Clay ❑ Adobe ❑ Hardpan ❑ i <br /> Previous0Application Made: (If yes,date_________________ _ ) No ❑ New Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ No ❑— "+ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: _ <br /> '(No septic +ank or cesspool permitted if public sewer is available within 200 feet-T- <br /> Septic Tank: Distance from nearest well___"570_ ___Distance from_foundation____Ad___�___-.Material'__ <br /> ---------- <br /> Size __---X_F_X_C_1Liquid depth------ - ------- <br /> Dispos ield:Eff jDistance from nearest well rte_-`-.Distance from foundation____/.p-'.....Distance to nearest lot�ine__�`_�______. <br /> Number of lines--------- .------------------Length of each line------- d -----------..Width of <br /> . _. trench. - .2 <br />