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, <br /> FOR OFFICE USE: <br /> pplication i hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> Installation will some: Resiclai Apartment House [] 'Commercial E] Trailer Court 0 Motel 0 Other 0 C-1 <br /> Number of living units: ../... Number of bedrooms,...R�Numbar of bat4_/.-Lot size <br /> Wafer Supply: Public System 0 Community system C] Pr*,ya to IV Depth to Water Table ....... ft <br /> Character of scill to a depth of 3 feef- Sand El Gravel 0 Sandy Loam 0 Clay Loam 0 Clay C] Ackilbe U-10HI'a <br /> Previous Application Made: (if yes,dote_.!*�M_. ) No Zr"`­New Construction: Yes F] No E30'Fl /VA: Yes C] No Ej <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No sop* tank or cesspool permfiltind'if public sewer is available within 200 feet.) 7 <br /> Septic Tank: Distance from nearest wall....70.Distance from founcIption...J..�2......Material... I <br /> Disposal Reld: Distance from nearest well... ....Distance from foundation...�V.4�......Distance to nearest lot line............... <br /> Number of lines.- Lengfh-of each ....Width of trench..... .......... <br /> Seepage Pit: Distance to nearest welL./e.a.,---Distance from founclation-2.Y0.......Distance to nearest lot �nj2i�...... % <br /> 0 Distance to nearest lot line..... <br /> Remodeling and/or repairing (6wsc,ibe):.......................... ......-^`~~.^`.^....................^..................................^~_._^`~^^~~~^^- <br /> f ... ........................................................~~~^----------------*--------------------------------------.--------------.--~ <br /> l ~ ...............-~----------------------------------------------------------------- ----------- ^-.,,,,........................._------------------------------------ <br /> ----------I..............................-........................... ..................................................................-.................. ....... .......... ..................... <br />� I hereby certify that I have prepared this application and.fhat the work will be done in accordance with San <br />� <br /> ordinances, State laws, *fthe San Jowqu� Local HwoKhQ�f� �� Joaquin � <br /> � ________________^, _______ a <br /> '-'-� -~(Si�n*d�-��� � -�^� / <br /> By:....................................`._........... ---------- .............................................____ ~ ........... <br />` (P�tplan. �wwv�g sm� mf &,� wfvy�m,� io ,*�flwnfvwalk, bw�d/ngo. w+c,. can <br /> �beplaced wwreverse v:dw). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED/ -- <br /> f <br /> REVIEWED BY � � �� ������------ ----- -AT-'-^�°--~�°^^""'--��----'--� <br /> ........... ......`.................................................. .......................... ............................................................... ........................ <br /> --�� � <br /> ­/..............................................................^~-^~.... -^..----__._-- ------,-.----------- -----------^~.-'-­.--`---^-`'.^-......... <br />� �---'�...............................................................~'_^'~--~..........------..........._-........................~^'-~~~............................. <br />� <br />^ <br /> FINAL INSPECTION D�*� <br />� � '��^-'~--`_^��--�-^.--'_.`~ ---'-.^_.~-.7_--^_~.-~._---`---' <br />� SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> 16*1 9.wm,wlesnAve. vw��Oak*�w, � 124 Sycamore Street zu5West p*S»^,, <br /> mow�",Caormma^-'---^-~°~ L^w/,Cw/^*w"k, Manteca,California ,,".',California <br /> E.av»*,.* ,""+"m�*" � <br />' . ^ <br /> � � <br />