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, <br /> FOR OFFICE USE: <br /> �! �l <br /> --------. <br /> APPLICATION FOR SANITATION PERMIT Permit No. ��ul--/�/���' <br /> (Complete-in =°p""a") Date Issued <br /> U the work herein described. <br /> This pplcutimade in compliance with County Ordinanc6 No. 549. <br /> / ^��� <br /> �9 �� ��x�� <br /> ^`^" "�"~^^^ "'~" "��' ----------f^'~~~— <br /> — --------------------------------- <br /> Address <br /> --.-------- Phone—.x—_--_---.—.. <br /> �----------------------------- <br /> k . <br /> Installation will serve: Residence [!rAparfment House E] Commercial [j Trailer Court Motel E] k�ther Lj <br /> Number of living units: Number of bedrooms --- Number of baths -.a.- Lot slize <br /> Water Supply: Public system Community system-[I Private-En"Se0h to Water Table j. <br /> Character of soil to a depth of 3 feet- Sand E] Grd�el Sandy Loam�O Clay Loam El Clay E-1 Adobe 0 Hardpan [4- <br /> Previous Application Made: (if <br /> ^ 1 ' � <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No ,w�tc tank or |pern�ted��om6Ucsewer � mvmUa�e`°� �� 200foe+J�--~—~-~' <br /> Septic Tank: Distfrom nearest well Distance from foundation M^+e,o| '^ <br /> Disp sZFeld: ;Distance from'nearest well ----- Distance frbrri�foundation---­1.1��-- -----bisfance to nearest lot line--47----I V11 <br /> i Type of.jilterma <br /> See elp.1 f: Disfc st well----1..0,6---------Distance from found -----tP__�---Distance to nearest lof.line... <br /> -------------- <br /> ------------------------------------------------ <br /> ------------------------------ ---az�_ -------A <br /> ------­--------------- -----------------------------------------------------------------------------------------------------I---------------__-------- ---------------------------- ------------------------ <br /> ---------- -------------:------------------------------------------------------------------------------------ ---------- ------------ <br /> -------- --------------------------------------------------------------* ------------------ <br /> I hereby certify that I have prepared This application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws.(Dnd rules and regulations of the San Jo aquin Local Health District. <br /> ------41 <br /> By:------------------ --------------------PA <br /> (Plot plan, showing size of lot, location off 4sysfern in r I�afion. to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> BU|U]|N8 PERMIT ISSUED----------------------------------------------------------------------------------------------- DATE--------------------------------------- <br /> AKu,uRonx and/or recommendations:-------------------------------- — ------------------------------------------------------------------------------------------- ----------------------------- <br /> ------------------------- -- ---------------------- ------ -------- --- ---------- --- ------------------------------------------- ----------------------------------- ---------------------- ---------- <br /> ---------------------------------------- ---------- -------------------------_- -------- ------------------------ ---------------------' --------------------------- ---- --------------------------------- --------- <br /> � <br /> '--'---------.—__—'—'-----_-----'----'--'''—''--'' -------------------------- �'�--- —''—'—'— <br /> ------------- --- ---------- ---- ...................... ....................... ---------------------------------------------- ........... ------ - - -------'--..--- '----' <br /> FINAL INSPECTION 0Y� �''----- Du+ov`�� <br /> 7 Cr <br /> -------------------------- ���__�'— <br />. ` <br /> SANJ ]AQU|NLOCALHEALTH DISTRICT <br />� <br /> 1601 E.xn"wto"A.e. 300 West Oak Street m*Sycamore Street uu5West 9th *,~", <br />� <br /> Stockton,California Lodi, California Manteca,California Tracy,California <br /> c.H.,ow/-67 Vanguard Press <br /> i� ' � <br />