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- ,.. . '.�,+r'T'. ,.. _-.,�.._., ti- yyy� •r— a 4,� i
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<br /> Permit No
<br /> g Date Issued _ _
<br /> it
<br /> as�a.��st��;� 1 �����='-r��:�
<br /> Qlacotion Is 17,erehy modo ffs3 the Son Joaquin Local Hea4h 134trlct $or r.:j pufmO to construct an n � 4vork herein
<br /> -scribed. hi* opp kation 4 made in comphanca Mh � ,nta C3 d;€�a f•t No, 5.49nr xlstin Rules an a ulatfanec
<br /> � . ... .-. CENSUS
<br /> EN5U3/T"t�l�C�4 ... ..... .
<br /> . ..
<br /> aATION ?'-' .. . .
<br /> JOB V3? r/ � .
<br /> r r
<br /> �a tier's ?olcame it' �......e.... ._...."............ :Trane ............ .................... .
<br /> c C T r I
<br /> Contractor's Name
<br /> lr stcalfation will R sI enCe 0 Apartment Hous '� Commerclai no
<br /> [jTrar9ter hurt �]
<br /> Motel [—�
<br /> €umber of living units.." .. Pv.umber of be&3onis -..._Garb ago Grirrdea Lot Sizes ----- ------------------------ -------------
<br /> Water Sugaply; Public System. and name --- " - ------------ ---.------Private ❑
<br /> Churracter of soil da a deapth of 3 feet $ and r� Slit❑ Clcxy � t:staandy Loam ❑ C;tay Loam 0
<br /> Hardpan 1.� Alois JD Fill Mate(iat ----..--- - if YOS, type ..............• -- -------
<br /> 'P101 plan, showing size of Int, IQ-a*lon of system In relciflori to wells, boildings, etc. must be placed on reverse side.)
<br /> NEW INSTALLATION: ;fro Fustic tank or seep;jga pit permitted if pubile sewer is ovcailoble within 200 feet,)
<br /> PACKAGE TREATMENT SEPTIC TANK
<br /> gazeLiquid Depthth
<br /> -----o --- -----
<br /> aapacity os C? N . Compartment
<br /> r
<br /> nj%ttance to nearest. Well ---...... --------------- Foundation .............. Prop. Line ._...-------- ----
<br /> i
<br /> : Iii IC tANE ) ) 6,Ire n` Unei __.,......_ Length of eoeia hne '��� Total Length _k���
<br /> 1=iY it srv°
<br /> :-Dep*? Fitter Mtater'cl
<br /> Distafl k6er:r"'3� . ....... Property Line ................ ....
<br /> .fir 'r Lack f=illet! Yes ❑
<br /> s A r )
<br /> Noo ,
<br /> Water Table Depth .................---
<br /> Distance to rrsaa'est: w@ui ...--".. . ............- _ .. ..e.,et=ouradatlan ----- - --•......... Prop, Line _._.....,.,.___-------
<br /> RFPAIR/ADDITION Wrev. Sanitation Permit Date ------
<br /> S
<br /> ---•S:pt'ac Tank (Specify Requirerrre"is) ............. -. .. . .. .... .........-eee_._. ..._..-..------.,.-..........................
<br /> L)ispG5.ai Eie.ia (specify Rec twee enipl .. . . _
<br /> ......... ................
<br /> pi-0,A,€.i taarcr am-1 n-quired adoi it-n, ora side)
<br /> I hereby ctttify ahca' I hove puma and this a ;�t.lr ;a e a P. ��r �:a: e tF vfl bQ dono In accordance with Son Joaquin
<br /> Count, Ordinances, Swe taw;, rind ids,,N Vre r A4:,Ai lom C4 tf.,;, g %i a-quan Lucal Health District. homes owner or iiten-
<br /> i-ed ugenls signature ramifies t,ro t to iso
<br /> a` tL $i{$f that 53t gin �6 R3 sYY�tli4"e x a4.{; p4>�'-Mi $.. ..y tali fi; I $#0.Ii # � *rnploy any person in such manner
<br /> x ;°t ay v,?z C-o '+r �;i, �,'4Af� �� �,salit0rgi,� a
<br /> �L9�I� i� ,sal.i�'!AF,.:$fl n 'ie
<br /> O D A egg^
<br /> .-
<br /> -
<br /> ..... DATE
<br /> APPLICATION ACCEPTED' DY T/���� Cfi,,� � ' �. ,,�_�'.� _✓_.
<br /> Lfii_ialNG PERMiT 1z .......DATE .
<br /> ,)nI TIONAC'e
<br /> Date
<br /> IY}.tt i4'15IJG'{:tl Ut? S±�^• —f :af,. .� 6 >r.•l>r s �.`.� ♦ ---- ... ..... .. / ✓- /. -t:-. ........
<br /> WSTRZICT 8/74 3M
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