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J APPLICATION FOR SANITAVON PERMIT Perm f x h
<br /> ' ICompkte in DupCufvj �y,`tTk'}may,
<br /> _ ! •s'.This Permit Enires'1 Yoar From Dot* ISSlled tyD-#oyFa lswd�'r
<br /> s• t Appheafion s hereby "on +c theSeri J.,a9uln Local Health District for a per It To consiroct end itll h�i"w,�.hi �n` R
<br /> '" T,hisv"eppin:at ode cc of ante W:-,r C"hfy Ord;,nce No. 549.
<br /> ' JOa AD^t q 'moi
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<br /> !' ,rstn 5n rory w 11 serve Rai^: ce /ionrfmanf Ho.zn Commerelal
<br /> .. . L,n. ❑ I].,:Tra,lar Court [ Mofil',
<br /> ;' 1 -baw of .'•a ur!ir ,.I. Numher cf bockoms :3:. Number of Laths ,�— !_of size
<br /> " Water Supply Pubnc
<br /> system �� r;omm .y sys4 �] Peva?e i.,i Dep
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<br /> �j1�Isifilt�f O{yW'0�4j4 441" 60. h' 3 feet: �,rd ❑ i n e ❑ Sarayy L.cerr, 1,v i or,i 9Y❑. Adobe Q He,
<br /> Prov em pl�G�#'[Or] ado:r.11f ye do!e- No New Cons{rat{oma "es ❑ Ft1ANA Yes
<br /> ' r STYPE CF ifATALLATION AND SPECIFICATIONS:
<br /> t [No ac+'c renF or cesspool permitfed if public sewer is availeblo wlf 1.n 1.17 feet.) .. r„ s rr
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<br /> roe. '� r u defi n LJ'� .._ f .•sore .'o roe ex+
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<br /> of f+er mefc lel I$ length .......
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<br /> �' ent- f_ romfouedetbn
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<br /> , "rl hereby eerWy that I have prepared rh's appl'ca{lon and ehef:the work will be dune m areo•dance with San Joaquin County k
<br /> ,K o,Jlnancet rlate'.!`ws end rules and regula�f`'om of the, San Joaquin Local Heelfh Drsiri<t, c `
<br /> "A' ' �> s(Slg!'d�tlZ� "�-r�-�.rdC ...ci-C.l.V-4ti� ..cl-.''�. -� !.-.t. (Owner and/ar Confra {ort s .?
<br /> r1 x 91v ,(Plo :.plan'Showing°axe of lof, loeefion of.y1f1m 1n r=le+ion fo wells, buildings,_eic., can be placed on reve-x• side).
<br /> k' yyyyvv..3 r FOR DEPARTMENT USE ONLY
<br /> �..unYIvM51 M� ��{h.}iI:R[Lnll Y �: .♦
<br /> I AYI 1{YN YI45d(o�NWIRYF NSE'
<br /> i APCATION ACCEPTED BY _ _ _;,•r.� .I.DATE a
<br /> DATE. rREeIF � e �qr ,A7
<br /> Aliareirrons and/or recommendations: ... ! :: " 1 d
<br /> g /�.,/ ,� u1 Com{./Y-(.i:.T7. �!•!t',/'' �z< � LCM ll�r �7f."�C.r�
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<br /> FINAC' IN FC{:i10"JBY Data
<br /> SAN JOAQUIN LOCAL HEALTH DISTRICT
<br /> t �1} `+ 9 "�^'1•^ 1a01/.IMu1Nn,A
<br /> W 1 5x 300 Woo Oek S1urr 114 SY(m:ere SMN 207 Woof Vln AnU
<br /> t'c is4 fGNWTk x „aP Ledl Col nla PA.".,.,Callie,nla Y4�
<br /> i stoddue,0a111amA��� - i,e(Y.r•CIIrNnle '
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