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<br /> FOR OFFICE USE: APKICAT16N FOR SANITATION PLqtMIT
<br /> JP ,;". .....f 7,
<br /> i (Cempl fe In Telpilot) a
<br /> .�................. .... `
<br /> Date lssuod ..Z::._.. 7�,
<br /> .. ._. Thls ilrettlt i�` fns�l tsar iiPaM�ilariunill ,J
<br /> �. ...._..... w +.
<br /> > ... ..� � .. a .
<br /> Application is hereby made to the Son Joagiiih Local Health District for a perrnit to construct and Install the work:heft
<br /> described. This application is made in compliance with County Ordinonce No. 319 and existing Rules and Regulations }
<br /> JOB ADDRESS/LOCATION ..I�A ./5/.... �/t�IYJ — .1... ..._CEIJSliS TRACT .......,..........._.
<br /> 5. Owner's
<br /> Name ..'C3 eZ.4.... 6/i:/CrtC��i+tt�'�I+►/.:�?JtC,�;�....................... . .............
<br /> Address ........r�C?., b K. ...'i .$7 ... City ......... �.... + S.
<br /> Contractor's Name ..........111'enle#i
<br /> t
<br /> ins llrtti�n will serve: Residence Q Apaitment House 0 Cott,tnerclal taller CMrt ❑
<br /> F� Motel[�C+ther s" �. ,,... . .... v
<br /> '> Number of living units:...... .. Number of'bod"ths .. ........C3aibagt: Gtir+der tdtSlxe ...c ,-Rr" --- ..... ;
<br /> t . Wcttlr S�upply� Public System nnCl name .... ..... .......: ..«......................... .... Privati t �
<br /> Character of soil to a depth o`3 feet: $and D Silt Clay [ Peat Q; 1 Sandy loam d Clay Loam IT'
<br /> NL..
<br /> f$.
<br /> Hardpan: C] Adobe Fill Material It y+ �Type`': .. . : 1
<br /> l Y • p...n e
<br /> z �WPltl't ls'n ., z of for leeatitin of ' 4 �fi� +~ a ,�. � �
<br /> chi �1 ;.� at ,��• n�: s•w. � ti ;a w
<br /> ,l p , s}towing si a sye yilC[tt 6 WI �11141M��, �, i�llikT,� pfi✓�d tsYt �weter t;11�:
<br /> T]�Y9'f11L1,�T10Nlt NO septic tank Ottt M fi i W11�1111'�IferF�� c p
<br /> ATMt:I�IT t ] SEPTIC TAI+) h ' � � € �
<br /> , Capacity u
<br /> ,..
<br /> lw
<br /> Dlstance to heatast� W411 F � . . F m p Lltt
<br /> i II GI Mi. No. of Lines : � ��a� .. � �� .
<br /> t ) ;�,, , , " fatal
<br /> Not 'D' Box ` : .»�..
<br /> ,,. -;',',��.�+r1V
<br /> syr • -. '`A?-,. - Disfarce ffl neanc�tt V1C{ili Ufw
<br /> 74s3
<br /> ItDepth .. jy t#tl stet ; y :mac s`�t e1t —Fl led Y { • No(`j°0
<br /> .. . M - �•
<br /> Water Table ?1td'„ '. r �4�f� .x�t
<br /> .�}
<br /> ._t aF `t trig + il
<br /> 1 Distance t0 nlltrlttl Well .t i �a ► i;. tIT16
<br /> _ `+' g"* .51T �Y -_'4�..�,? �: 41 '' Y�'R�a►-ewi fin. ..w �L;S: k..;yy 7�. .z�F,:. K
<br /> _(Prev. Sanitation
<br /> r. an I fii R"Wre"ntsil t g ; .�.
<br /> Ii� dTetl Fleld (Specify R uI entf} � r W16,
<br /> ',+ .
<br /> r + ems
<br /> �k �� t 4 uks vts d"�t4€•G+ (r.r Cela
<br /> .+ ......................... .s ..ti f i L a. a s ,b.q y � a ..... ................-
<br /> �.... #Draw ettirwtlatg aridii��l e�ittei�t�r�l�e'ei+�r.)�� �,�•. �•"�� ,;;�.
<br /> �r cag +n,;*•9J°-Y� •�4t
<br /> : Yriii4* Deist I have prlgarrd trhle "011 # taihi wfu it deli! lfll. ,
<br /> ti r.4 w :
<br /> AxL � " l stat! Lawry and Itw" aMaif r it e au nln i� iTlaltlt �.I>l�twa et►iiaijnr:
<br /> th!ttltflrmanat
<br /> of I tlelr T .ii►+ ► /lt; �1. t't!t Nt Itt7t
<br /> e ii/ Orkrna s laws-, Ii'1 W -
<br /> Slgrtsd L]yVrIK. r e 3 F F r p
<br /> _ ..(If _ � .....................
<br /> i4 •:APPLICATION ACCEPTED BY ... .. .. . DAT!'s{'.���l�A
<br /> BUILDING PERMIT ISSUED .. .... ..... <f
<br /> AbE+ITIONAL COMMENTS ..,... . . a c ... ... .........
<br /> .................. ... ..... . ...:....
<br /> A
<br /> ............................................ .... :_....- t -.... -„ '! .
<br /> . ... ».........«.
<br /> Final inspection byx
<br /> "' IDAQt)iN ftOC�l't;tlf►.TH 1,6t
<br /> i6a� I
<br /> 01
<br /> E.H. 9 1•'68 ev. SM a �,
<br /> ">- !s.!3x"�` _<.rt��ISae'p�r��a+�.,.,.,t,x,s.. ..,x �. _ ... . e.1,i,��\*'.�=^t'.� '� .�S .M`A t-w�• - r'. ..x�,,. r•�' '�1
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