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I FOR WHCE LSE E ? d Tsti c^ r a K "
<br /> APPLICATION FOR SANITATION PERMIT Permit No
<br /> i (compsaf. in Duplicate; y
<br /> Date Issued
<br /> This Parm.+t Eaer.r_s.1_Yom From Data klued ��.�`G•�.
<br /> p,Ft +Ca o's es nerady n'ocv to '!sa Sen Joa<t:.r,:• 'oca Hoath J.;r,.cr f;: n xrarrnit Or ar•a -.""t.1 `he Wort -•era;- do �s
<br /> 'ns apolrcotron•;'t made,/ ee e::;r innf. .�'f f"otr tr C}rd;aeruo No 4i4 (,(J�tS1~ r1
<br /> J3JYST84—A II tT ® rcLE? pf
<br /> 3rJ9 A'Erant» Ar „iArij!(}I•,i.q� `t � t ��r��+�% �4
<br /> .;)w. r a F:ar-.s =• V` • !�1 i� SCREW A N Pq+o•nr. �jv 573,v f
<br /> Addfost .. ..7� ..•._tttlp t>1C34g0� e��' '-x
<br /> Conffactx; , ltlm t 14 Rok( y4 - A ....;.L Phonac#IG ilrrlll
<br /> Iastaution w0 sarva: (Ra=.;do.^co 9 Aqa-trnen' Ho.va -:j s;, .*rart,al U 1'(&:0, Court F) mo-el 'C] CMrvnr Cl
<br /> N,;rrt c- o' I.vrnq un;ts: I hunber o' ccd.wrns '2/ tJdr-rtJcr u! E-0`hx � .nf Si,n /7.�M.G+�
<br /> S
<br /> 'Mater supply: PJOf c system (] Cofr.n".0y ,
<br /> system � j pr;•.ato� Dept* tz WaterTet:lo�T. f•. -
<br /> f.r.
<br /> C"ractor of sal to • depth of I feat+ $arcs.a G-avol [, Sandy C.:ey Loam J C'ay D Adobe ZI Hespan L]
<br /> Previous App!<ca+;" Mado: yes.cora 1 No Now C c.+::trur:t,nn yes Lj N FHA,,VA Yes L oit
<br /> TYPE OF INSTALLATION AND SPECIFICATIONS: s.� _ tt
<br /> (No sepl:c teals or cesspool perntifted H public sewor is availettla within 200 foof.) \ t
<br /> as t�1s`�•i ��++C/ " �r,rc..r r,r: Di.txr._e front f tw,danor I !.rata
<br /> r t'"f"r'r'I 'ern rp [tn srl f wCD1<."r ��+.'`*•.
<br /> f �V/-/� /t , YY ••
<br /> .. `-/.. • , "a+S+oi+ roll MVy :1 tnCw �rCrn Irv.•rjA`.Gft 0c. OOA•a It IJf
<br /> o' hcn�•n-ya', r
<br /> �'^-- � .:_ •^a•nr al fp!n f.it . main';nl / Alt t •.pi rc�gfA Cry I
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<br /> ` orlc ,r.
<br /> rrl! +,al 'f J'-r d
<br /> .:* , •.•.ov ^r�
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<br /> {Jrrr..�_ -..•" 1 i5 L,r rr, ....i 91 mm�rCr ''r p',
<br /> �:.r.xpx•. ..t_+ , rea•r:! .r,!I L� raxe
<br /> qt
<br /> 1 ho.abY eor4y teat I havo praporod this epp cation and that lbs work wi$1 bo Bono in accordance ,.ith San Joagveee Cownty t
<br /> ardbrancos, state 1"�la' And r"es &nnd reoe
<br /> qulatioea of the Son Joaqum Lai Hv*14h�Dittr;ct. r -�
<br /> (Sigaad'( '"' h R Lt.
<br /> ,�Q ll,/ (Owner and/of Gontrec!orlt`�`,
<br /> (10164 plan, showi sae of iof, {apation of sysfcm rr relatbuidingt, etc.. can 6o pla�{�a�� an reverrsa a:dn).
<br /> FOR DEPARTMENT USE ONLY
<br /> APPI CAT'N A(7�C`rPTFD Far�^'�✓.,':''f✓r�.L•s"� {SA'E �-.��f ,
<br /> Rrv1E'wE0 c" DATE t
<br /> 8'3i,,DlNG PERNItt 1SUET7 DATE
<br /> Alterations and/'or racantrnnadat+orrs:
<br /> SAN .'OAQUIN LOCAL HEALTH 66STMT
<br /> took 6. Narrka.A.s. Yea W.sr Qet ia.rr r t+S,rw.r.r.%,..•
<br /> 74S ,aor M 5rn+,
<br /> t..aat,e,(,atafanw taq.. Lm,fa,.-ie Wm<v. Ger,rs,»W
<br /> 1•acv-Ca-awrtie
<br />
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