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FOR OFFICE USE: <br /> _----__------------------_..--.... APPLICATION FOR SANITATION PERMIT Permit No. . _ s <br />-------------•-- ------- ---- -------------------------- (Complete in Duplicate) Y .' <br /> ------------------------------ This Permit Expires 1 Year From Date Issued Date Issued ...... ......... .... <br /> Applicatio--is'hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This applceionis�m e'iIilcompliance with County Ordinance No 549. Ci.J,ll= rf wit. F_ of SEXTa�d <br /> JOB ADDR _� ESS AND LOCATION._ ._1.✓,����P_�- •---------- �[ [�_� � ��`� <br /> . ................r----------------------- <br /> _--�'- _ <br /> Owner's-`Name t1�7 RZF/ T:C��`-------------------- r Phone k:72.=..7e_4(!7. <br /> Address.................. ,� 47• -•r--' r x_eaAa <br /> �r vle--------cel,(J_+Ga ,_`Ot ......y 6_ <br /> Contractor's Name-------0-6r2e--------- Iwe -----_----_ Phone.t l r-.Zni 77A k. <br /> Installation will serve: Residence gg Apartment Hose.❑. Commercia E] Trailer Court E] Motel [3 Other El <br /> Number of living units: ._1---- Number of bedroom _:__ Number of baths __i___ Lot size ------- ----------------------- <br /> Water Supply: Public system ❑ Community system Private R Me pth To Water Table YO ft. a <br /> PP ( Y 4 I Sandy Loam Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ <br /> Previous Application Made: If es,date__Y=____� }' No .—New C hstruction: <br />