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m �..-. APPLICATION FOR SANITATION PERMIT Permit No. ..... .��m�m� � `--`—' Duplicate)—Date |omo6 -�.�l!,�� Applica4-ion is hereby made to the San Joaquin Local Health District for u permit tpconstruct and insfuU the work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION -------------��'«�° �.....-S.------. Jr- 3 C/ =r -,A - --------------------------------- Contractor's Name .......................................... 4, — ----------------------- Installation will serve: Residence 2---Aparfment House Commercial E] Trailer Court [] Mofel E] Other E] Number of living units: Number of bedrooms _��umber of baths Lot size ...... ------------- Water Supply: Public syster'� [i��Community system El Private 0 Depth to Water Table.,;W ft. Character of soil to a depth of 3 feet: Sand E] Gravel [] Sandy Loam E] Clay Loam [j Clay El Adobe 9 --"Hardpan E] Previous Application Made: Yes L] No [�-�ew Construction: Yes E] No Ej TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer isavailable within 200 feet.) Distance from nearest woU.,-........... Distance from foundation ................... kJutarluL-...................................... __ No.ofcompartments ------ ------------------- Size ............. --............. Liquid depth .......................... Capacity. .................... ' QoQsal |6 Distance -from nearest wo|LJN�. ...Di,tonce from fovndutiun-�/^J�.-Di�ance to nearest lot line -.��.�— Number of lines / .,-Length of each iino� �� �'. Width of trench Type of filter material ...............L...... of filter material.-: } length 5eapage 5t� Distance h, n�wn�+ ~aU'�� un6u�on-'��_—��t ncufo ne°,o�|n� |inu--"�[7.�. ' Number of p�s'-��'-'--�n|ng material- -'Gro: D�m �^--_Daoth.��x0�.~~ - . Cesspool: Distance from nearest well -''._-Distance�rnm{oun6ot�n--''—._L�ing material., ----------- -----` [� Size: Diameter �h . --�.---.L�vi6 Capacity --'gals. � ',' ~ -' ` Privy: D��nno`,qm neo�o *oU.~'---_��--_----D�t nce fn�m nearest 6m&6iog------______� [] Distance to nearest lot line ---------- ------- -------------------------------------------------- -------------------------------------------------------------- Remodeling end/or repairing (describe): ................................ �'�---_-'--._'''''-'--''---_-'_------______-__ . ^ / . `' '--_-.--'-_--'''----.'---'--'-_''--'-_-'----'----`,_''--.---_-'_—''-_'-----.---- ��_��_��'��'��_��'�_''_��'�...._........_....._��...........------------------ ��--` ,_ __—_----------�� / , Sfmfw ' rules and I f, � le 44* cation of system in relation to 611s, buildin (Plot plan, showing size of lot, lo s, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY BUILDINGPERMIT |S3UED.'-................................................................................................. DATE —...................... ----------------- -..---- Alte,a}ion»and/or recommendations: ................. _-....... ..................... ..................................................... ............................ ----._--- � ............. .......................................................................... ......... .................. .......... ............................................... ______ �—_._-'--'''-_.............. -''------'-_--__---'--_-.................... . � .............................................. ......................................... _'--'—'—''-----_—'---'--'_--_---__'—,_'_ � _~ -' _� FINAL INSPECTION BY: --[��'------------- Da+e---' -�--.x��-��-------.� .' � SAN JOAQU|NLOCAL HEALTH DISTRICT 130 South American Street 3ouWest Oak Street 132 Sycamore Street 814 North "C" Street