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Jr . <br /> FOR OFFICE UmE , <br /> ' 10 | <br /> ��V \ Permit-'--- FOR SANITATION PERMIT �r � Pwrmit Nw <br /> Date Issued <br /> Application is hereby made to the San Joaquin Local Health Dist rict for a permit to consti4uct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION_..__2_,__.3._/�-----------&.........­...5_�7Z ........../-----I ................ ... ------------------------------ <br /> A66rass---- ------ --�----- <br /> Contractor's Name................................ ..'` . .................... Phone.................................. <br /> - <br /> Installation � �'�� Residence � Apartment House � �mm��| � l�Umr C�� � Motel [� Other <br /> [] <br /> �� �� <br /> Number of living units: '�' Number of bedrooms 7.. Number of ����Lot size ..._��..... ���� .............. <br /> - <br /> Water Supply; Public system El Community system [] Private 2- [�epfh to Water Ta6|exnxi-ft. | <br /> Character wfsail to w depth of 3 feet: Sand [] E;,uvm| [] Sandy Loam [3 Clay Loam [] Clay [] Adobe Hardpan [l f~ <br /> Previous Application Made: {|fyev, ) No [] New Construction: Yes [] No [3 FHA/VA' Yes [] No \ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: D --'Dis+ance from foundution---.-----kxmta,iuL-.-------_-----.--.. <br /> 36*� N ~-u��me��- --'Size-_.-------.-.-Liquid q �epfh--------..(�a9a6t�---__---- <br /> ,- ' -- ` <br /> DisposalRn|6' Distance nearest ��|| ,���^..D�f n�afnxmfoun�oHon__��"=--'D|�mn�oto ��u,o� �� Une-.-�-�__ � <br /> � . -� � <br /> NumberLengthof each kne.__-r��x_-'YY|d+ of +n�oh__._-:�~�.�_- V � <br /> -- Typo of filter material.- Depth of filter mat a,iaL''r^�f���'Tofu| ------------ ^� <br /> Seepage Pit: Distance to nearest well-------------------.-Distance from foundation....................Distance to nearest lot line................ <br /> Remodeling and/or repairing (describe a4 f�l-- -- -------------/ <br /> I A� j <br /> ------------- <br /> I hereby certify hat I have prepared this application and that the work will be done in accordance with San Joaquirr-Gourdy__1, <br /> ordinances, State laws. and rules and regulations of the San Joaquin Local Health District. <br /> Bm---______.-_-.__--_--__-__-_____._____--.__\,n��.--._----_-.--- -----� <br /> �� '�' �� � �� ��� � ��m � ��p � �m� ��� �� m� �� �� � ��� �6� <br /> ` �� ._n. »nw~/n� '' .�� . <br /> FOR DEPARTMENT USE ONLY <br /> ^^^^^^`''~` '^~~^^ '^~ `'------------- '-��--'~-'-'---r------------- ' - ' <br /> �/��------------------------------------------------------------ <br /> REVIEWED BY'--'-__--__-..��--_.---._------_----------- <br /> � WU|LD|NGPERMIT ISSUED--------------------------------------------------------------_-------------------------------------- DATE''-_'_-'-'''-''-'''______ ~ <br /> Altermtionsand/or :----------- ------------------------- -....................... --------------------------------------------------------------------------------------------- <br /> --------------_-__----.--._-_._-------._--_-___---_.----_---'--_''_-'-__--''-_----.'--'. <br /> ---------------------------------------------------------------'------ JJ <br /> ______________ ____''_ ----------------------------------------------------- ------------------------- '-'--'--''--'''---''--'-' <br /> ------.-_------. ---_.__-_-- __._.. <br /> �-_ <br /> RN/\L INSPECTION BY� -- --'-1�����*--------------------------- Date�'^���� -------- <br /> ------------------------------------------------ <br /> SAN <br /> --._-----._--_-- <br /> SAN JOAQO|N LOCAL HEALTH DISTRICT <br />� <br /> ��x��e�v� �W��»� 1o«��o� �W��S� <br />. <br /> Sl"ckm" California ' Lodi,California Manteca,California Tracy,California <br /> "" v REVISED °°o u* °'°/ ^*^" _- <br /> ~w <br />