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�y99r,M�m, <br /> USX, <br /> y ` +'..ts`re1,p*sT+ '& ! <br /> Perm It `� ` <br /> dPPLIC11Yt0P! f-0K 5AA11TA3iOi P a{ <br /> (Cmmp(a1e iro Trfppzateaf No T t7Ava - <br /> q <br /> ...>. :. .... ... Thin Permit -. DareisAuod�S'� ' s <br /> Fxpireo J Year hmre Dai itsu'" <br /> .A <br /> eet,pt on�'a e made ade to the San Jaagv'n Local Health Disfrict fora Per o construct and x <br /> nit tIndfall ttN week,hreTA`' <br /> apr.i cu•;a is made 'n cominionce with County Ordinance No 549:and mwitrirtp R'I and RpafaMomr„ �.?x, <br /> .:otF CENSUS s b. <br /> ,�^ . ._-.- ... TRACT ry: S 5�r� <br /> Owa s Ncrnps . d�P C^.r {r.... VANRFJZ... , ,Et�. ane .4x <br /> Address . ..../ 1. c'.-�.. E— LYvi -. Gry !1/ . ✓y <br /> Controctcx's Name . -.-.Ucersv #., Phone ...:: r4 <br /> ..... . .:. ._ .. .. }d <br /> 9 In[tallat<sn wiVl serrm, Residence DrKportrnent House 0 Commercial .__}Trailer Covoi <br /> - _ Motel (,other ' <br /> 1 ... } �j tf t^ <br /> Nu be or g units....- yl Number of bedrooms �Cr t+age,Grinder /l!Q Lor Sr:m /Yff\.�n.E,-F.... <br /> Gs^.aracte• r "'cSyetar, and'namo ...:: ,t-/. l�s PrlvafA'��t' <br /> Water S' >aly, <br /> of so I to o depth of 3 feet: Sund i,] Silt rJ Cloy 0 Peat[] Sandy Loam �L� Ctay Loam Q ( F <br /> Hardpon Q.... Adobe. Fill Malarial N�.if yes, <br /> s <br /> (Pio* plan,,show -' sPze of lot, lomtion of system 'n relation to wells, build;-gs, etc. must be otacad on revoaa sldo j , rtFsi} <br /> r NFW INSTALLATION:'.. (No septic tank or seepage pit permitted if public sewer is available within,200 feet,) <br /> x <br /> i PACKAGE TREATMENT f ? SEPTIC TANK Liquid <br /> { ) Size ..... L quid Depth ... <br /> "pacify -:_. Ty Material Na Compartmmnts, <br /> Dat ante to nearest Well ........Foundation ... Prop. Line <br /> e __.. <br /> .EA CHIN, LINE f ).. No. of Lines .. ... .. - ._:. . ,Length of each line ..:._. ._... ,otat .Length .-.:: . .. ._..._ _ ' s <br /> 'D'; Box .!_....:.. Type Filte Material .._ _.....Depth Filter ate!ial ` <br /> iy! <br /> DiT Di <br /> ' F'' stance to nearest. Well.. Foundation ........ __ Property Line . <br /> SEEPh., <br /> Depth !.._.:. Diam ter Number ........ Rock Filled Yet 0 No C � ti <br /> Water Table Depth ..._.. . . _.. - .....Rock Sze.... <br /> Distance to nearest: Well .....,.1._.._ .......Foundatio _.._._ Prop. Line ...... <br /> REPAIR/ADDITION(Prev. Sanitation Permit# ... ...:.._.................... Date ........ ._.._.._} - <br /> Septic Tank (Specify Requirements) .:. ...__ . . .:....................... <br /> ... . ..._ , :__ .:.._ <br /> 1, � <br /> Disposal Field (Specify. Requirements) CO/V[VZ:-<7 T'✓7 . XIDI /111 .jy$lM� _.� _.... <br /> s . 7 �aAtr� An,� 1.VE�............... i =- <br /> (Draw existing and required addition on reverse side) - <br /> i hereby certify that I have prepared this appliealion.'and that the work will be done in accordance +1. Stn Joaquin <br /> County Ordinances, State Laws, and Rules and Regulations of the San.Joaquin Local Health District. H.... owner or Ikon- <br /> sad agents signature certifies the following: 1/7 <br /> - <br /> "I certifyqJ%[�,j�'a t penton ante of thew for Ica this permit is istuWf shall not employ any person in such manner <br /> Cs to b?/"!"sw� tt to r/brkman' �mp saHo_..aws of Coliforn%.iZ/ f <br /> IIVV// <br /> .oed :. . . q. <br /> P /'.. f<�.. Title <br /> '''r other than owner) ! ,� <br /> FOR DEPARTMENT USE ONLYt <br /> APPL,CATION ACCEPTED BY 1. 1. �`' -.. . . ... DATET�n..-� <br /> 9UILDING PERMIT. ISSUED..... ... . ... _.. ---- . _DATE.... .--_.. ... <br /> ADDITIONAL COMMENTS ...... . ....._.. ...: ..:.. ... .- <br /> .. .. ... .. .. .. . <br /> -_.. ::.: . .:. ... - ... . .. <br /> Fnol lnspec .. .. ..;0 . _ ___ Date ... <br /> SAN JOAOUIN LOCAL Fr.ALTH DISTRICT <br /> E H. 9 1.'68 Rev, 5M C <br />