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� ����[]{���'����� ����' ^��[TATI���� PERMIT Permit No. <br /> . ~ <br /> nUuafe <br /> 7n �w <br /> � rC°'pe'~ Duplicate) Doha Issued ' <br /> , <br /> App <br /> ||cuton is hereby made tuthe.San Joaquin Local Health Dist rictfor uper mit toconstruct and install the work hereindescribed. <br /> v [hisopp|icotion |s made in compliance with County Ordinance No. 549. ' <br /> -------------------------------- <br /> Owner's Name------- Z7 <br /> �,, V - - -------.. y�one.^��a��.��a�.�*��-. ' <br /> noo,�,�`�-�..��� --' <br /> i �Ie.� ---------------- Phone------------------------ <br /> Contractor's Name. V71 <br /> Installation will serve: Residence P0 Apartme i nt House 0 Commercial L] Trailer Court 0 Motel E] Other <br /> Number of I�ving units: ---/_ Number of-bedrooms Number of baths ---/__ Lot size ---- ---------------- <br /> Water Supply; Public system W Community:system E] Private E] Depth to Water Table <br /> Character of soil to a depth of feet: Sand EGravel E] Sandy Loam E] Clay Loam [] Clay [] Adobe Z Hord0an [] . <br /> Previous Application Made: Yo, E] No E] 'New Cqns+rucfion: Yes 0 No 0 FHA/VA. Yey Ll No F1 � <br /> TYPE OF INSTALLATION AND SPGC\F|CAJ|ONS: . <br /> (Nn septic tank or'cesspwo| po,/n|Ma6 if public sewer i, available within 200 feet.) <br /> t. Tank: Distance from nrorn`+ U istance from foundo6 ���ata,iuL-c��osyu�x���-�--_--- <br /> No. nfcompartments---1- ---Size-- ----...Liquid/�oPf�-------------------------Copadfy-"152------- <br /> . � <br /> -^Disposal )e/6: Distance from nearest well----------Distancu from foundation-__---'Distance to nearest |o! line----------------- <br /> Number of lines------------------------------------Length of each line------------------------------ of french----------------------------------- <br /> Type <br /> '_-'-'-''-'-'- <br /> Typu of filter material -.11----------------Depth of filter material-------------- Total �length.-.--_---__.-- <br /> 5uepage Hf: D�stonce t, nearest *o|L'''_---''Dis+onca from foundation -_---'_--Distance +v nearest lot line----------------- <br /> F] <br /> '---''-F] ' Nv 6er of pits----------------------Lining material _--�- -----Size: Diameter_- -------------Depth............-------------------- � <br /> n,uu � Distance from neo�� well----------------- from foundo�on'-�'�---�n�g mofer�L--''-'-''---'- '�( <br /> � \ ' Size: Diameter---------------------------------------Dept --''''''-_---''''-''''--Uqui6 Capacity-------------- --------------gals. ^ <br /> Privy: Distance from nearest well-------------- ----------------------------------DiStdno, from ,onnmf building ----------- .---------- ._-� <br /> D4tunce to-nearest lot line- --------------------------------------------- ''-'-'---' <br /> --'--�emo�� <br /> / <br /> ------------------------------------------ <br /> ------------ <br /> '_-.----''-'--' ` <br /> --.c -_-.__----�--''-^--'--------'--'------�p---'''----'''-'---''--''--'--'------'-- / <br /> ---�_-.__--_-----_-`'_-__---__-__----------___-__.--_--_-____._--------.-.. � <br />- have prepared +hisand that the work will be.done in accordance with San Joaquin County <br /> ordinances, $fate laws, and rules and regulations of the San Joaquin Local Health District. <br /> ,'°--~---' <br /> H"lo+ plan, xho*ing �ca��nwf'sys�vninrm|a+�ntowe|�. bun � <br /> �|n�oo� ' nanuep�codonro°e,m*mmo� ' <br /> . . <br /> FOR DEPARTMENT USE ONLY <br /> �8. � <br /> APPLICATION ACCEPTED BY..�,�'. .---.---.__.-_-_-'-� DATE----------------------------------------- _---- <br /> RENEw/ED BY------------------------------------------------------------------------------------ DATE''-''''''--.'''-----_----_ <br /> BU|LD|NG PERMIT ISSUED------------------------------- ----------------------------------------------------------------------- u^/E---_------------^.'__.. <br /> A|+orationoan6/o, recommendations------------------------------------------- -------------------------- ------------------------------------------------------------------------------------------ <br /> i -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------........------------ <br /> --------------------------------------------- ------------------------------ ------------------ ----------------------------------------------------------- '------------------------------------------------------------- <br /> _. <br /> --------------------------- -------- <br />� <br /> ------------------------------------ ----'---''-'''''---'''-_'''�-''---'-'' ------------------------------------------ <br />' �7.- �� <br /> � �RNAL INSPECTION DY' ^ ' ' Dnh�''''//.'./-'�'-',-_''-''-''---_-__ <br /> . - .�^ -~--'_' -'-''''- <br /> SAN J0w\QU|N LOCAL HEALTH DISTRICT � <br /> 130 South m"°,ic_ Street »mnWest Oak Street /»z Sycamorestr°° 814 North "C" Street <br /> St""u"". California Lodi, California w*nm*°, California n"c*, California <br /> ES-9-2M m".a°6 1'57 p.pzu <br />