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'~~"''~-^"^` <br />,- <br />-�x---' <br />' / <br />- APPLICATION FOR SANITATIONPERMIT PermitNo. <br />(Complete -' <br />i <br />Do�, 1om^e6 "- .Thi . . <br />b°�on ' Made to the San Joaquin 1ocal Heallh District for ' permit to construct and install the work herein described. <br />` <br />This application is made'in complian�e with County Ordinance No. 549. e - <br />Installation will serve: Residence Apartment House Commercial E] Trailer Court E] Motel E] Other [_1 <br />Number of living' units: ^` .. ' umbo, of 6adn,omo,;�~e'�.. Lot size.-°����=. ----'_-- ' <br />' � Number of 6m+h� - <br />WaterPublicsystem` ' [] Communitysystem El Private JZ Depth to Wafer Table ft. <br />' <br />Character bfsoil toadepth of 3 feet: SandEj Sandy Loam [] Clay Loam {layAdobe JE- Hardpan C] <br />Previous Application Made:, (If ' 'cite -------------------- >/ �o [] Now Construction: Yes No [] FHA/VA. Yes E] No D <br />TYPE OFINSTALLAT|ON'AND SPECIFICATIONS: <br />(No Septicp6rmiffed if pti6lic sew.er.is available within 200 feet.) <br />' <br />Septic Tank: DistanEe <br />4' N -±�� id 6 <br />Disposal Field: Distance from nm4resf woU��1�����Dis�0nce`fn0'm foundation -------------------- Distance to nearest lot line --��-�'- <br />|� 4 <br />. '. . -- - 'Total. length --- _-'''_--'--_-'_- <br />- _ . - <br />Seepage Pi*f �. �- -'- :4!7�Distante 6n <br />� . N ��o~ ' �������� �������~ ^`^' `| ' ' ----' <br />Cesspoo|: <br />- <br />Distnovfi:o <br />[] S;zv Dim Doo!6 . <br />Privy: Distance from neor6m+well -----.-!-----_-----Distance from nrwm,s+ building --------------------------- <br />D <br />�t�nco h,'����� �� U�--------- <br />Remodeling and/or repairing (describe) -------------------- <br />''''-------------------------- <br />--------------------------- -------------------------- ------ ________------------ <br />-----.-�'---.'-'-'-''--''-�_-_- .--�--^___—.-___._---___.—'-----_--.-___'-_--_-- <br />------------------------------------------------------- ------- y-__.____---__--.-�.--_-_____.--__-__-_---____—_----_--. <br />� - <br />-1 he'risby certify -that I have piePared Ais application and that the work will be dand in accordance with San Joaquin County <br />ordinances, State laws, and.rules and regulations of the San Joaquin Local Health District. <br />(Plot plan. showing size'�of lot. location 'of system in'relation to wells,,61.1ildings, efc., can 6e placed on reverse side). <br />FO <br />iR DEPARTMENT USE ONLY <br />APPLICATION <br />~�- DATE _.. <br />REV|EWED DY.--._---_'_-.-�-.-_.-----_._---.__-`__--'-__ DATE ------------------------------ <br />BUILDING PERMIT ISSUED '_-'�-.-`''-_''—.'---'--'__'-_--'''-_.'''-''''-- DATE. ------------------------------ <br />------- <br />/ <br />------- <br />----­------------------------ <br />------------------------ <br />Alterations and/or re M <br />� <br />. <br />com~�'- —'�~~~+'''�~~^- ~=" <br />-------------- <br />----------------------------------------- ---------------------------------------------------------------------------------------- �-__-_--..__-'-��-._.-�__._---' <br />� � <br />--'-''--''_--'—_-'-'----''''-'��'''''''-''''_--'-''--''''-''''-_'-'-_.'-'--''_------ -------------------------- <br />------------------------------------------- ------------------ ---------------------------------------------------------- ------ ---'--''--'--'-'-- <br />` <br />FIN/\L INSPECTION -- Dote''- ^----_---'------''------------------------------------- <br />------------- <br />SAN <br />�.------''-_----' <br />SAN JOAQUiN LOCAL HEALTH DISTRICT <br />130 Sou th.Arn erEcon Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br />Stockton, California . Lodi, California ' ' Manteca, California Tracy, California <br />ES -9 REVISED ~",��6, ZM 5-60 <br />