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� APPLICATION FOR SANITATION PERMIT Permit No. <br /> ����mp/efe �� �u�|��f�) <br /> Date |oonJ <br /> h 'is hereby made to the Sun Joaquin Local HoulH` D�f,�t for a permit to construct and in�aUthe~or" herein described.r <br /> oupp|ico�on is made in compliance with County }niN 549.6 <br /> Owner's Name-_ <br /> --------------------------------- <br /> Installation will serve: Residence parfment House [I Commercial F] Trailer Court E] Motel 0 Other <br /> Number of living units: _/--- Number of bedrooms e?-- Number of-baths -/- Lot size <br /> Water Supply: Public system Community system El Private [-] Depth to Water Table <br /> Character of soil to a depth of 3 feet: SandSandy LoaClay Loam El Clay 0 Adobe ,clpan E] � <br /> Previous Application Made: Yes El. No Now Construction: Ye, =�o � <br /> TYPE OF INSTALLATION AND SPBJH6ATONS: <br /> (No septic tank or cesspool permitted R public sewer W available *ifhin 200 feet.) <br /> Distance from nearest well-----------------Distance from foun6u+�on-------------------Material <br /> ---.--._-- <br /> No. of compartments--------------------- ----Size--------------------------------Liquid clep�k--------------- ----------Capacity-._''_---' <br /> d, D;st ncr from nearest well------ - ----Distance from foundation--------------------Distance to nearest lot line--- <br /> Number o6 lines------------------------------------ of each line------------------------------ of hnnc6--.. -- — <br /> ' K Type of filter mutmriaL''-'' Depthof filter moh,6oL -To+o| length <br /> U +�oc� , n�m , w � � ^Soepa - <br /> �onxotu n�un:o� |o+ |i"e ''� <br /> �- x�- ^ - . <br /> ��- Num6erofp� ' -.�-..Lini"g'mn1ur�o| ����� Diumcn����� ��..°-_Depf�-'�.��..-~ --_ <br /> Cesspool: Distance from nearest well-----------------Distance from foundation------------------ Lining material <br /> ' <br /> ced on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> _- m�-_ <br /> *_-_h_-_, <br /> _h_u <br /> L] Size: [ omofe�'-''-'--'— � L_''._- <br /> _�-_-_--_-'_-- <br /> ---_--_'_-�- <br /> - <br /> _- <br /> —'— � '''-''''-_'-----'--- �pi6 Capacity -__. <br /> Privy: D�| ncr from nearest well � <br /> LJ Distance to nou",`t |o+ Sno--. aomneur ,fu �g_--_. -____'_______�_.____._____ _� - __�- <br /> _ <br /> Remode|�g and/or repairing (describe):.---�''--�_._''-_-''-_____.______.__ <br /> ������''���'����������������^������������-�`�����������'���'��'�------------------------- <br /> -- <br /> �-`�`� <br /> -_-'-'-_.-'__---'___'_-_-''_-�-_.'----__-__'-----_..__--_—__--_----_--___----,- ---._- <br /> '�-''---'—'-''��-'------'-_.''__---_-'--___.'''-'_--'--_----'--_''--'''-,--- <br /> uin County <br /> ordinances, S 7a laws, and rules and re.gulations of the San Joaquin Local Health-District. <br /> (Si ou) <br /> (Plot plan, showing size of lotj� -�Vio_n_o ys-f-ern in relation to wells, buildings, etc., can be p_ <br /> APPLICATION ' —~- '-~ `'- -'^'—''^-'=� '==`-"~= --'--'-_-._' ux/�� <br /> -- <br /> REVIEWED Kl'— � ''--'--'' <br /> -'-'-- ------------------­­BUILDING PERMIT ISSUED'-_-'''-- - -'-'' -------' <br /> '''--'''-''_''---'--.__--'-_'_-.''-- DATE _-- <br /> ----------- <br /> Alterations and/or recommendations:---------_-- <br /> --''--_''_-'''-'--'''--''''-'''--''-''_---''''---'�---'--_''---'-''-''-''_-___.-'-_._-_--._-- <br /> -----'-'-'-'---_.--.'''--''''-''--''-''''-''-_-_''---'-_.''--'''-_.--_-.-_.'-_.''-'--'_ __'-'-' <br /> �'�_����'����������'���-��'����������_�����'��������������_����'������ <br /> --''- -''--'''---'''''---'''_'-''''—''-'''--''-'--'---''-'''--'''''''-'''-�''-''--' - `'--'-- <br /> RNAL INSPECTION BY:--� ''-''--- Date-_` —'-''/K'''-''-''''---'--' <br /> SAN JOAQ0N LOCAL HEALTH DISTRICT <br /> /so South A�°��" Street 3ouvomo° s�"° on Sycamore �'�+ e14 North ^c^ s�°� <br /> Stockton, California Lodi, California Manteca, California <br />