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FOR OFFICE USE, APPUCATION IM SANITATION PWW <br /> . -53 <br /> Permit No...7.... 3 <br /> ......_.... <br /> .....:..................... (iompieN In Trlptel <br /> lfas , <br /> :..........:......... ........................ Date lswad..7:'.a/ <br /> This Penelt Expires I Year From DIN issued <br /> Application Is hereby made to the' Joaquin Local Health District for a permit to tonttnict olid instolF the work heroin <br /> described.This applicatlon Is mad `In compliance with County Ordinance No. 544 and existing Rulei c7nd Regulations, <br /> MSF .......7..rpad�Ty <br /> \ <br /> .. . . CS' <br /> JOB ADDRESS/LOCAT ...1.-1.......17....... / . N ` <br /> Owner's Name ......... tLI..fA....._. .....................................................Phone .........../...._..�.......... <br /> .. <br /> 2 [[fyf +J ._..........:.... City <br /> Address ... . <br /> '..-..............-I._..._.. .._._ ....._. <br /> � pp/ .License# ........................ Phone ........__....._......_..._. <br /> Contractor's Name ......�:.t...._..... ................_...._. ....__ <br /> installation will serve, Reidenes Apartment Hots}e�0 Commercial j]Tmller CIM <br /> • ^'- Mote(•j�t:lt➢utr......:....:..:....:...:...:...._.-.-:::�:,. ` <br /> Number of living units:.---.... Nitler of bedrooms 3------Garbage Grinder/4VS- Lot Size J ''+• -^` N <br /> Water Supply, Public System and n&me .....................----...—..........................._I. ........._..._.. _.._.. ... ...PrHaN❑ <br /> Character of soil to-a-depth cf3feeh__Sand.j3 Silt « Cloy_Q-q-`fko► Scl}d ta°m Q CJay to°m <br /> ' `rl:[] Flit K -4 �-s............. <br /> ` , Hdpan p' =Adobe <br /> !Piot plan, showing size of lot, Irotwtlon of system in relation to welts, buildingi! etc must be Placed on reverse side.) } <br /> NEW iNSTALLATION_t (No sere �e�(taA orgZe a pit perrnMW If j1 blige�tsewe�4availobie within 200 feet,} <br /> PACKAGE TREATMENT-It-SEPTI _TAN .lf��............-._...- Liquid Depth ....�fT_..... ... v) <br /> Rirr�� F9FI n w/d.R _-, ......� ---. <br /> Copadty iY.�............ Type J?I.�F-sem— of_.._.._ .moo:•Compartments r� f <br /> t <br /> Distance nowash Well' .__,/rQV......... .....Foundatieyer�Q.�............ Prop.Line...__- _�.. <br /> LEACHING LINE [r� o. of tl s .... t .... . . Length of .. 111 • x/..=`....- Total Length 1. -r.. <br /> ....... �j 6 <br /> • fiox�J �Type Filter Material .(7.� �Z ..Depth Filter Material ...� .............:..............J..._. <br /> s r i ' <br /> Distance t� neareit, Well .10e........... foundation la Property Line . ..!`�•........-.•• <br /> SEEPAGE PNo CM <br /> lT Q ➢ De4 _---i........._.L Diameter _............ ............................ Rock Filled Yet ❑ <br /> Wa r Ta� Deoth .. ! .Rock Size ................ ........... N i <br /> ! IDist once t➢o nearest,WeN ......._.._.._...._'.L__. ... ._Famdatio�—n-.{{.................. Prop. Line ....._. ... ..-. <br /> ` REPAnt/ADDITION(Prev. Sanitatdon ParmlttP ..... Date ._._........f.._._. .-..-.➢ <br /> r <br /> ...__.......................... <br /> Septic Tank (Specify Regjlrerne IKL��..... Mc�A _L _ .._.j.__._......_...�`:._... _......D sposal Field (Specify Requir➢ ants) -__• ................ ........_. .................._.........`.....__..... <br /> ...........................__....._..._........._.._.... <br /> _......................:........ ..........................:.......................... .. . to <br /> _................ . ................................................._............_.....__............._..._........._..._;.._._......__..i_':::.... <br /> (Draw existing and required-additlomtt o n reverse-si i- <br /> I hereby certify that I have Prepared this application and that the w" win bs Gone In aaerdance 4�Hi•,Sloiti; Joaquin <br /> County Ordinances, State Laws, cad Rules and Regulations of the San Joaquin Lac l Health Distrid. Nom► evvner er licen- <br /> sed agents signature fies the following: <br /> "I certify tho the ormon it the w rk for which this permit Is issued, 1 shall not employ any person In such manner <br /> as tobecom{/ubject o kIn is o laws of California." <br /> Signed J.�vf Z 4 ..-.-.-_- Owner - <br /> g ... ......r.... ......... .M - <br /> tifotheLthaa.owne _ <br /> FOR DE-PARTMENT USE ONLY <br /> APPLICATIONACCEPTED BY....± ..t .. ............................................................................. DATE ......:7-.3 ..75-......... <br /> : <br /> .. !.�.. ...........:.................... . ........._...........:.......................DATE..............._............... <br /> BUILDING. PERMIT ISSUED ....:. ,.........._. <br /> ADDITIONALCOMMENTS .... .... . ................. . ......... ..... '........................................................................_......:................... <br /> .. . .. ....................... - 9'-- ------...-...- ...- ..........:................."................--..........................�..._..........: <br /> ... .. .._ .... .. <br /> : .... .. 1e ... .... .. ... '.. ' <br /> t <br /> j Finol Ins , s..:............................Da .. ' <br /> EH 13 2➢t 1-611 Rov. sm SAN JOAQUIN LOCAL HEALTH DISTRICT 8/94 3M <br />