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APPLICATION FOR SANITATION PERMIT Permit No. <br /> ' <br /> h�mm�e� � Duplicate)(Complete '--' D*fv |ouo6 <br /> Application is hereby made to the Son J aquin Local Health Dist rict for a perml to construct and install the work herein described. <br /> This apRllc�fion 1 made in compiiance th County rdinalN o. 549. <br /> 'jOB ,-w,,,,SYAAN_P, LOCATION--- -- ----------- --- ------I-- ----- ------- <br /> �i JL-------- <br /> Contractor's Name-------- X �+'l - ----- ----- ------ -- � -jl ___ <br /> -------------- ------ A -11 ----- ---- -- -------- <br /> C.mme' <br /> Installation will serve: Resi encek"Apal mein House E] Commercial E] railer Court El Motel Of her E] <br /> Number of living units: J--- Number of bedrooms _%.7 Number of baths /---- Lot size --—----------------- <br /> Wafer Supply: Public system El Community system 5?-Friv`a�e [-] Depth to )Y.ater.Tab 0-!'r <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam 2--c-"lay Loam Eil]May!j�_ <br /> I Adobe [] Hardpan El <br /> Previous Application Made- Yes [] No F�i�New Construction: Yes J2-N6 E] FHA/VA: Yes F1 No <br /> SPECIFICATIONS- <br /> (No septic tank or cesspool permitted if pl sewer is avm8m6|e within 200 feet.) <br /> Septic>- - <br /> � ^��} <br /> _- from _ _- Distance <br /> � <br /> �! _-' - <br /> ty- <br /> Dispos | Distance from �b&.�� D�A?coe"fromfo d <br /> Number of lines Length of each line-12.0------- -------Width of trench---c4?J!�' <br /> ------------- <br /> Seepage Pit: Distance to neo,vutweU°24NO----------D unclu+ion---ZV__ <br /> Num6erci pits---/----------------Lining material!- --Size: Diameter-m51�------ <br /> Cesspool: Distance fnolm nearest well-----------------Distance fnom foundation--------------------Lining mote,iaL-''-'''_-'-_''- <br /> El Size: Diameter-------------------------------------- ...... ---------------------------------------------Liquid Capacity-- <br /> KJ <br /> Privy: Distance from nearest *oU--''''-''--''--'''-Ob+anxe from neom,+ building.'--''_-.-__.''--'\ <br /> Ej ^ Distance to nearest |o+ line------------------------------------------------------------------------ '_-_--_----._-_---.--- � <br /> ' <br /> "° ---'--'''-'--- � <br /> ..��� .���l��- .�~�~£~/��_o[��L. -...-__----.--.--._-� <br /> -----------------------_'----____.__.'�_--___-_-'--------------------------�.-'-_.-''-----__.-----..__.-._----.-._-. <br /> ------------------------------------ ----------------------------------------- --------------------------'-------------------------------------------------------------'����-­­------'����'----------- <br /> 1 od thl Ica _,al that the work will be done in accordance with San Joaquin County <br /> nay <br /> ordinances, <br /> p�noop. � <br /> pqnt lashowing size of lot, location of system in relation ' <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION -------------------------------------------------- <br /> REV|EWB] BY----------------------------- DATE- <br /> QU|LD|NG PERMIT ISSUED------------ �^��_ D�TE � ~ <br /> _-'-_-__--.___'-_-_---_- DATE-- -------------------------------------------------- <br /> Alterations recommendations:----------------------------------------------------------------------------------------------------------- ------- -------------------------------------- <br /> ----------- ---------------------.--------------------------------------------------------------------------------------------------------------------------------------- -------------------------- <br /> ---------------_---__--_-__----._-----_------�_--.__----_--___--_--_----__-__--._. <br /> ---`--'`-`--````---`-`````-`-`--``----``--'```---````-``````---````----```---`--`-``-`--`-``--'-`- <br /> _._---.__----------_----_----'_------___-_----_-------------._-_-_-_ <br /> FIN/\L INSPECTION BY ------- --- ---------- -�'�--'''----''--'-''- <br /> SAN JOvAQ0N LOCAL HEALTH DISTRICT <br /> /so South Am°a"= s*°"» oon West Oak e,°°+ /sz Sycamore Street mw North ^C^ $+==t <br /> Stn"ktv", California i»d/. California mm"*°nm. California rmxv. California <br />