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, . `- ~- ' - �7�� +y �� _ ~ x`rr�/x~m`/�� r�'p� S��m|o»�|I��n4 PERMIT R No. ' (Complete in Duplicate) Date Issued - 'g A plication is hereby'made to the San Joaquin. Local Health District for a permit to construct and insfo the work herein described. is application comp�ance with County Ordinance No. �l � ' ^`^" """~ESo AND Lv~~n//un_-A --- ------------------ Owner's __'.__... "_= s Name---------------------------' _��_�~»�x�_ Phone..��L�� *��_. ' ' Contractor's' ' _____ ��-----'''-----'-----------' � - . ------------------------ .Phone-----__�.__-,-_- ��R� will serve: �sidence 0 Apartment House E] Commercial Trai|e'r Court L] Motel El Other n -� Number of living units: 'l- Number of bedrooms ��- Number of baths ..4Lot size _ 6 0~..%r�� ~~-_---' Wafor Supply: Public system.[]. Community system [] P,ho+o A Depth toWafer' TablaitzJ49 ft Character ofooil to m depth of 3 feet: Sand [-] Gravel [] Sandy Loam11Clay Loam [] Clay E] Hardpan E] Previous ApplicationMade. Yes E] No 5?' New Construction: Yes Vf No F-1 TYPE OF INSTALLATION AND SPECIFICATIONS: � ' (No septic tank or cmyqaoo| permitted if public sewer is available within 200 feet.) ' ~ =~ �- Septic Tank: Distance from nearest well-4,2)------DisfWa ,;rorn foundation _ Material--lc-CR - _ -,--_.cortts_..~^__--,-~ .� y�p,"-n~*-p�--_'`.opoo,ys�.*Nof --7--------' DisFosa| Field: Distance from nearest well-A04 -D T'Ofndufi,n' "�-�-D�� to nearest lot line � ' N�' �� - . Tvpn of filter ma1o�uL� -�Doof of filter mo+o�o| _ To+o| �nof ---------��,..__._.. ~^�` Pit: Distance to nearest �nU..*��.�� D n_^�J�~~~J)istance to nearest 12t |im� 1KNum6er �� p�,''^�~-'''-U��g materia S�e: Diameter--.0-3 w� ---Dnpfh'��---°'-'-''- �~~ Cesspool: Distance from nearest well -_-_--.Distance from foundation ------------------Lining material __---_-'-__- LJ Sizv: Diameter-'�-''''_--'----Depth---------------------------------- -----------------Liquid Capacity'----_.' - Privy: Distance from nearest well------------ ---.__.___-O�+once from neonstbuilding------------------------------------------ L] Distance to nearest lot |�e --------------------------------------------------------------------------------------------------------- Remodeling and/or ,epoiring -'`'''--'--__'''----__--__.-.__---___.______________.__..._____^. ----'-'-'----'-----''-'----r------------'------------------------------------�-'------------'-------'' --------------------------------------------------------------------------------------------------------------------------_------_.--------------------------------------------------------------------- --'----'-'-------''---`-------'-----'------'-'--'--------'-----'``--'`--``------'```-` | ho, m+ | have^ prepared This application and that the work will be done in accordance with San Joaquin County -ordinances, S�tafe laws, and le and regulatiA of the San Joaquin Local Health District. of -9 '(Plo+ plan,'s owing size of lot, I bcation of ystem in ir�lation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED B\L_.-''- ~ -^�,�' DATE. ' REVIEWED DY--------------- � p~�' v'--�-----''`----'--' E—��" ----' -''-�'--''''-'''''��—�-'-'''---�''-'''',- DATE. � ----- -------------------- ___._______ BUILDING PERMIT |SSUE[\'-�'�'-_-'''_-''-''-��-''�-.'-''-'�-''''''-''' DATE�''---_.'--_-.'-_''____. - Alfera+ion, mn6/or ,ocommon6*#onx/-_------------- - ---- -__-_---------_--..__-_---____�_.__. �__ ^ --''-_'-''--''�,-'---'�__-''_'''--�''-'��'--'''-_---'��-'''''--'''''-�--'-_-----_'__.-___.-__. r . '-''--�--''--''-'-'-''''^-'-''','-��--'---''--��''---_''----'' �-_.''-''-_-'��'--_-''-_.'_--_'- ----------------------------------------- --------------------- ------------------------------------------------------------------ -------------------------------------------------------------------------------------------- -'--�''-'-'--'''''��--'''---''-- - '''''--,`.'--''�'�'---''''-'-�'�_'''_-''�'__.'--'' ^ FINAL |N3PE�TC8V _^ ___ On��___ -' *�� ~'��_-.��__�_________ SAN JOAQU/N LOCAL HEALTH DISTRICT ./»o y""e American Street 300 West Oak Street oz Sycamore Street ow North "C" Street ' Stockton, California Lodi, California Manteca, California Tracy, California ! ES-9-2M na/ no.aed vv-2/00 � r . �"