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7.i yp7 s.Ks T`_ .N FCR 0fTl V.Rr <br /> APiICATmN FMSANITATION Pr-`UT <br /> Permit No..:1�a2.� +4 � <br /> 1'CArmplo1e M Top"caw k`fto� <br /> This hrtitlr 6*11 s t Yoe.Front Deb kswd Dane Issued:✓q,C, l�" { <br /> y'Sa s <br /> } Zi1 F <br /> r£ Ilpplkatkm is �5 y fri h y <br /> hMeI,Y trade ro the Sort Joaquin Local Health District for a permit to constrvci and Install the wark.ltorein <br /> desart'bid.,Tltts appliaotian is made in wmpiiance with County Ordinance No. 549 and existing Rotes and Rapttictions: } <br /> AnDRPsS/lOCATION ,d, � <br /> r� C ��F .� �.....l Y'. ... V-J[Fid..'A`.- .. J�f-•.-.....F.w- -........_.vc��.7VJ�,�7�.' <br /> ' �Owtters Ntl � �� <br /> rf�Cfl�1sL��s ��$` <br /> (}= y+� a#,...:r spy. 'q �e _�_. �-�y..................................... . •`fit' <br /> ,v..f <br /> Contractor's IVartto1� ................................. <br /> LlcMtse p/ a� � <br /> ' anon will RQStdemCe � COrnrrte F=� <br /> �rr is t�`� t�vQe Apartment H • ,fl ��. <br /> !t]Troiter Court <br /> 4 .�1. �' �• �' 4 n Motel Q other.... _��_.yy..��....................�_}- � - I � �^Rn �j M% ��'�- �*rT.t�� � �f' #.•. <br /> �/MiR rt:ia <br /> NuenlnerFaf living units: Number of bedrooms e3.».Garbage Grincfar . r !ot 5iuC'Cl �'r1f".}'.w �?: � �N. <br /> f � Supply Public Systart and name <br /> WQter _..................__.............�..... $ <br /> ... -Private�';wf x, ', wy r <br /> ``f� Chtlr atner of soil to a depth of 3 feet. Sand U Silt❑ Clay 0 Peat 0 Sandy loam�, Cloy L' <br /> r" ���r r <br /> ' 'k � . ,; �" s j ' ' , 3 . Hardpan E] Adobe 13 FII Material. .If s'type41 <br /> : '�.• r � # � <br /> s � .. yet -_•• :C.. �' <br /> { ' (Flat plan;showingsize' of lot locationstem o f In relation to wells, buildings efc.f:mtnt be.placii! nntessiWej�` ` <br /> r <br /> illEiN f1�TALLATION (IVa septic tank or seepage pit permitted If public sewer is available within 200 fast} ' � { <br /> y rr <br /> " ,t1 1 �,r,J.PAC:KAM TRI:ATMV IT:`;j, 'SEPTIC TANK(] size.... .....................: .'.. � Liquid¢Depth r= s <br /> 4i; Fi �r , i>acitY <br /> .....,. Type ......... aterlal:........_.. ..� No Com"_eras <br /> > j ,�� � Distance to nearest, Well .......... ....... .........Foundation � �L PCap.Line <br /> LEACHING LINE G..[ of Lines} ....................... tol lenpt�t `' � <br /> w - ..... .. Type Filter MaWal ... ........ Depth Filter aterial;' <br /> No of II <br /> 'D' Box <br /> '� � 4 Property <br /> rhe <br /> � I g o <br /> A 1 six , til i;' Distance to nearest: Well ..................... .... <br /> Foundation ... ....: Pro i <br /> NY, <br /> { '� _ ..... .... Y <br /> t I , UEPAGE.IT ,[ j Depot ..........`........... Diameter ........... Nurmiser .......:...... j Rock fFllacl Yes pJ No <br /> Water Table Depth ............... ...... _.. ....__.Rock Size. _ z, ;x i <br /> t } Ian,# M <br /> s��� r,, �" "•, Distance to nearest, Well <br /> .r A <br /> ...................... .............. Po <br /> Line s <br /> 7 WAI R/ADDITION(Priv.Sanitation Permit#............................. .......... Da <br /> Et f <br /> c T.a.!n (Specify <br /> ecLi^rf�y'R'eVqu_ir.ements} ... •yam'►�7�^........�....../.T. .. . �..j_ <br /> .._. ."._. __""ai LysN.tr <br /> .,.. <br /> Di sol Field Requirements) _---......... .. ................................. <br /> . ..._... "± r� fd!` - <br /> ....... <br /> ........... <br /> i <br /> .......... Y' <br /> Pr=e.isting d requin!d addition on reverse side} <br /> I k•r - I hereby certify that I.have prepared this application and that the work will be done in accordance wifh,San�Jeaquln 'tK <br /> w } <br /> County Ordinances,.State Laws, and Rules and Regulations of the San Joaquin Local Health District.Home ownirr ot•Itutt- - Fy <br /> sed ageits signature certifies the following: <br /> t'U `"t ceAify that in "performance of the work for which this pes•.mit is issued, I shall not employ any p'Grson in such niannlr '# <br /> 4 as to become subject to Work n's CompensaHan lows of California." <br /> _ <br /> Signed �............. .................Owner { ! .f y•rt.'�� <br /> .. Qr� 'r "C .. <br /> f By ....... ....... Title_... . <br /> {If other than owner} v 's. . <br /> ' ! FOR DEPARTMENT USE.ONLY <br /> APPLICATION ACCEPTED BY................. ............... .................._..�....✓. •'. c(s:/ ! •.t.... DATE.....-J-ru../..........__c........'. i <br /> BUILDING.PERMIT ISSUED......._............ . ...F......................................._ ..... .... DATE....... ........................:.......... <br /> ADDITIONAL COMMENTS....... .............................................................. <br /> } t �.i/C: ...................... 4 <br /> S sped a y:... .. .. -. ..1.,L�/Ll...._..Dcle ..... ... .. .�............. .. ...... k <br /> t SAN JOAQUIN LOCAL HEALTH QISTRICT <br /> E.H. 9 1-'68 Rev.5M C, <br /> io <br /> rfi <br />