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. . <br /> � <br /> . / <br /> ' -APPLICATION `F���� SANITATION,PERMIT Pwnm�1�o -.-.�-�-��- <br /> ' <br /> in Duplicate) Du� |s�n6 _7/��7�� <br /> - ,2 / <br /> Applidalion is hereby made to the Son Joaquin Local Health District for a permit to construct and in*all thework herein described. <br /> This application is made in compliance with County Ordinance No. 549. 40, ea-s" <br /> JOB ADDRESS ANW LOCATION ----- ---- <br /> ­*---------C_ L <br /> ------ --- -- <br /> 211afion will serve: Res-id-e-n-ce []----Ap-a-rtmenf--House--E]----Commercial E] Trailer Court E3 Motel 1:1 Other.ld*_ <br /> Number of living units-- -------- Number of bedrooms ........ Number f baths -------- Lot size -Y A���------------------------- <br /> ater Supply: Public system [I Community system E] Private ;�D fh t Water Table -------- ft. 1. <br /> mev <br /> Character of soil to a depth of 3 feet:i Sand C] Gravel E] Sandy Loa Clay Loam [I Clay El Adobe[3 Hard1pan El <br /> Previous Application Made: Yes E] No E� New Construction: Yes 2� No E] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if, ublic sewer is available within 200 feet.) <br /> Sept.ic Tank: Distance from.nearest well jjstai�ce frpm fogsljation_W��af <br /> D�stance from foundafioni bistance to nearest lot lin <br /> Disposal Field: Distance from nearest welia"_f& of <br /> Seepage Pit: Distance to nearest well------------- --------Distance from foundation------------- ......Distance to nearest lot line--------------- <br /> -^---------------------'----'---------''--''--''---''----'-----'---------' <br /> ---'_-.''_�-''-'--_-------.'-_'_-.'-_^---''''--__.''-_-'--'''--'__.-'---'--'___-'--''-''-'-_� <br /> | that | have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances,'— 'State | ' d rules and regulations of the San Joaquin Lmuo| Health District. � <br /> (Signed) <br /> ------------.----------..`---�--'�Owner and/u, Contractor) � <br /> ________\ ____�� __________�_.___�__--'''--''Oit�L_---''--''----'—'-''-'-'-' ' <br /> (Plot plan. �zo�m� �+ |�� �wn mfoyotem in relation to wells, 6uildingo, o+c., can be placed on reverse side). \ <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATIONACCEPTED BYi. ------------------- - -------------------------- -- ------------ --------------------------- DATE:3��— -------- --------------------------------- <br /> -------------- <br /> 01"t fl_� <br />' _____.____.______---.-------------'�x,'-----=-'—''°+-'--'--'—'-------'---' <br /> ______�___________________________________________________________ <br /> �_ � �__��_�_ ������������ <br /> /F <br /> FINAL INSPECTION BY: <br /> '—������~v'-' '------' <br /> SAN JOAQUUN LOCAL HEALTH DISTRICT <br /> ".I South American Street #NWest Oak Street /xn Sycamore Street v/° North CStreet <br /> California Lodi, California Manteca, California Tracy. California <br /> \5446 - <br /> ^°WOU" 12-54 <br /> ~�4k -`- <br />