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FOR Om <br /> 'y ��������^����� ^���'��.��UT������� ������� Permit No. <br /> (Complete in Duplicate) Date Issued ... <br /> Application is hereby made to the <br /> San Joaquin Local H ^ l+h District for a permit toconstruct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> « <br /> ka C��, /6 10-- <br /> ""=°,S.'-. . <br /> Contructo, m <br /> Installation will serve: Residence Apartment House'E] Commercial El Trailer Court C-] I [] Other [I, <br /> Number of living. . units:. -^ .~. ~~~..~.~^ ............................... <br /> . `x�'' '`~^'~~ ~' ^~^'^ -- '' --' --- ---'----'- <br /> Water Supply: Public system nity system 0 Private [] Depth to Water Tmble.3.A. ft <br /> ' � Clay Loam [] Clay [] Adobe 8--Hardpan [] <br /> Previous' <br /> ' mli*atimn Made: (|fyes ----) No New Construction: Yes 5KNo [] pHA/VA. Yes [l Non�~~, <br /> TYPE OF -- U-t . <br /> (No septic tank or cesspool permitted @Fpublic wewler is available within 200 feet.) ' --- � <br /> Septic Tank- Dist noe.frovn nearest woQ'---------------Distance from foundation--------------------Material --_—_-........................... <br /> No. ofcompartments�-._--_-- 6mot '--Ca __ <br /> �isposal <br /> - . ` / ' <br /> � D xmU'-'''_'Di�unc� from foundation--------------------Distance to nearest lot line,-.-,............ <br /> Nor�6er_of_|ine��r�-i_-------Length of each line--__--_____Width nftrench_—._-----_-. � <br /> Typo of filter muteriui_.-----. Depth of filter material -Jotu| length ' __.__- __ . <br /> Seepage Pit: f 'Distance to'"eurost woL -.Distunco from foundation ^ Distance' to nearest lot '4 <br /> Number of pits-------1-1-----------Lining motoriui -Size: Dia meter- -_Daoth.�Z��,-��*�( <br /> / ^ . ` . <br /> Cesspool: Distance from nearest well----------------- from foundation------------------- Uning moterioL.--'-_—._._- <br /> [] Size: D�m�toc _-..�.___-�--Dooth'---'''''--.'''--------------------Liquid --------------------------- <br /> > » <br /> Privy- Distance from nn*rmofw�|—''---''-_.'---''._,�,'D�+anc� from neon�+ Lu8d�g/�''_-.''-'--.-'-'- <br /> . / <br /> [] D|stunoo to nearest lot line--------- -_'_--------___.---'---''- -._--''-.—.---Remodeling — � <br /> ) � <br /> and/or ' ! <br /> ------'_'--_._-L---_-._~_-..__.-�-------_--_--- - -__._.—l�-.. | <br /> �� �� <br /> ----..��---_-_-.---_.-.__--. _-_------_'-_--.-''-....--.-----.--.'--.--- --....-.-----.--.----.. <br /> ._______._______.___.__. � _________________.___________..___------------------------------------------------------------- <br /> I <br /> - _.__._.________ l\ ' <br /> 6 ' 61 dfhAhe p�k'Wil| bb-6 hiance with San Joaquin County <br /> ardinenc. fe laws. and rules and regulations of the San Joaquin Local Health w,m,/ct. <br /> ''-' Contractor) . <br /> -,-_ ......�_ ---------------------------------------- <br /> � relation to wells. etc., can be placed on reverse x0m1 - <br /> FOR DEPARTMENT USE ONLY <br /> � <br /> �_�����__------ -------------------- �_�------------------------------------------------------------------------------------------------------------------------------ <br /> ------------- ----------------'--------------------'------'------- <br /> . � <br /> --''-''-'--''-- ''''-''----------I............... ------­---------------------- <br /> .4- <br /> FINAL <br /> -''—'RWAL INSPECTION BYDu �� -. -������--- <br /> SAN JOAQU|N LOCAL HEALTH D|STR� T - <br /> 130 South Am°w"anw=et 3wwWest Oak Street 1ooSycamore Street uouWest pmStreet <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> "" 9 ""=""" °'= "" "'°/ ^,=" _ � <br />