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APPLiCATION FOR PERfYtIT <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE., STOCKTON, CA <br /> Telephone (209) 466.6781 <br /> PERMIT EXPIRES 1 YEAR FROM DATE ISSUED <br /> (Complete'in Triplicate) <br /> u <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and/or instati the work herein described.Th{s application is <br /> made in compli*,e W;th San Joaquin County Ordfpancp No,549 for 60tivage or No. 1862 for yell/pump and the Rules and Regulations of the San Joaquin <br /> Local Health District. 4 <br /> -~ S City Lot Size adI 7 PM <br /> i <br /> Job Address <br /> 1 />L� Phone 0 73 46 �9 <br /> Owner's Name gOti, f Address <br /> TGA �✓ ' cense No, e� ��—/ Phone3�` 3 <br /> Contractor's Name -�_ <br />