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<br /> APPLICATION FOR SANITATION PERMIT
<br /> lComplotein Trlpllcotsl
<br /> Permit iVo. .. "
<br /> This irermslt Expires 1 Ya From Dot®Issued Dott
<br /> A p�tbcotion Is hereby rna o to the San Joaquin loco; Health District for a per-it to eon;rruct and install tMs'work lsifsin ��
<br /> clescribecl.l'h.s a'ppl'ication is mode In compliance with County Or&nance No, 549 ond -'xistinq Rules and ReQubHonfr
<br /> .1011 etDDRI S AOCATIOIyI �. .�... . CERiSEJS TRJICT
<br /> r ' '0wr4r s Name : Phone
<br /> t i Adclrrst 6 �a.71 city . /1111%�r . . .. , }
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<br /> !"G'�t .-� r",..-..License
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<br /> tractor r�larrSe .. f�1, ... a •.
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<br /> InrtollOtlon w Ill serve" Residenc6 Apartment Hovso t o ao-nereial( ]Teai!er C Jif
<br /> y f iu°:s¢tg .Motel [�
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<br /> ' t un tt:.,=. tJ�a^bei of bedroom$ ..�2. Gcxrbafye Grinder : t Suet Y ¢_'
<br /> ;SEG 1i "St)pp�y Public System and rams _.:. ...........y : pIbVOM
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<br /> r t o �aclstc soia sJetpth o$3 feet. sand[j ; Silt E3 Clay � Pocit❑ Sandy Lona» , Clay roam Q4
<br /> n.% •. Hard�an 7 'Adobe
<br /> .:. �r Fifl Mateel If wec,<?P � 5-a
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<br /> plan ish /I size of lot, location of system;in relation t® wells, buildirsgs, etc, gust be placed On tewrfr sbsr
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<br /> IN septic Conk or see ,e it rmit'ed„}f ubi4r sewer is aura 1. be'ttthin'2t>a.feertl
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<br /> I��►"d►GEFR`'f�tt ►*fM f 1 1FPTIC TAIIK 9 m
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<br /> Capacity ::...... Type .... ,. Material 4� - Carrtparinnettfs ejl
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<br /> r' D+stance to nPr�,est well ,,xr: , f.., :: Foundation i pitLir11
<br /> I}o, of Lints . .. {' Length` o each line Total Length
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<br /> `D` Box Type )liter° Material Crdzprh Frlfer �`.i4rial< t, .
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<br /> Distance to nearostr Well . ... ..... ....... Foundation ProQirry Line
<br /> rpt ( �Ga Depth ...:: Diameter Number Rock Filled Ye1t
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<br /> Vlotrr Table Depth ............ ... ... ......... ......... . Rock Size
<br /> lFoundr✓tiors Prop. Lira C
<br /> Dfstonce to nearest° '',/deli ..,, =
<br /> ttt AIRJACDMCN.iP'ev, San;tolt on Permit Grote 1
<br /> 5ephe Tank (Specify Requirements)
<br /> rementsl
<br /> :DtsposaiFeld {Specify Requirements! . ,�E'C- ��`1.......o�d .. ....ter..... ✓ .. ...1. .t 1✓
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<br /> tt (?raw existing and rer�uired addition on reverse side}
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<br /> 1 ho ( !+ave re creel this fa IicAtion,and that, Iasi work will be dor in aece mance wills Sew J�egsslss
<br /> p P ' t' ,, Pso-p )f+<,Na m r<wrY+r$trP"'wa -
<br /> Cevnftt inoncev"., Srarw isfs;and Rules and<Regulations esEf fhefSan Joc auin Local Fl al It tHyArl t.fiense errvewt er Ilei
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<br /> ,etge+n 5 GgRU exre�eertifles t sf'e”following � ��+� �< 'g �'
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<br /> '1'reesrtify t saf In �podormanee'of+tbe viyork,for which this peret+ff,l:,issued,I sheal� nor «,+nptny any persaw t,A st+ds w+essw+es
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<br /> /o be+iee�sub lo. ,..ro an saConpensatfioni lows of C.ylffornta
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<br /> APPLICATION ACCEPTED
<br /> DATE .
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<br /> BURDING PERMIT I SStiEl
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