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FOR OFfKE USE <br /> %APPLICATION.FOR SANITATION PERMIT Parmlt Net. <br /> ' (Cc;epie+e is Duplicate) <br /> TMs Permit Eeoires i Year From Data, Issued Dat' hwood <br /> by made to the Sen q S- o ftb- <br /> Th s�apprcetipn made in c49. <br /> r ri� Courty G dipatnca Nae 5for a permit to construct and install tM work herein deon+bed. <br /> peN <br /> JOB ADDRESS AN LOCATi K)i'rtv._ . -....�/�c�y...1;2G' <br /> ........ . .... <br /> Owners NamL-`�- �RB�RT._ .-THt �R,Y Phase <br /> Addnew.._._.RxE. .1. aZ.70............ <br /> �1P.. f7.n► <br /> COnaKt*r'r Name... _Q.vt1.t!I��._.. ., . ..,�. ...... .... .. ...._.......... Phone_. .. <br /> .. ... ...t <br /> MAaBetir .. .. ... ..... . .._.._606166" sr78 arsri: Residers❑ Apartment Haus ❑ Comrnae:ei ❑ Trailer Care �MMeF Q Other Q <br /> t t �j . <br /> Nimber of Iiving units: . ._ Number of bedrooms Number of beths _._... Lot sae <br /> ll <br /> Water Supply: Nbfic tyvem, ❑ Comnwpity system Pr;Vat* ❑ Depth To.Water Table,�'� ft, <br /> Character of wil to a depth of 7 het: Sand�Grovei❑ Sandy Loom"Cfey Loom C3 clay Q Adobe❑ HerdOen C <br /> io <br /> Pre. us Appiicetiou Made; (if yes,doM ' l No New Construcfion: Yes No ❑ FMA/VA, Yes C, No <br /> _— TYPE Of�INSTALLATIONt;nFP«TF ed if puS blIc a ~ Is aveveieblewhilph�ti20 on _*# <br /> Septic nk Datanee from nearest well 150 Distance from <br /> No. of compertrrynts _.;? �^ SKe�t.)(.��....�C..J�.1 rW d dot th . �7� CePK,N.. f�'r <br /> D spas old �Outenca from nearest well ,.�f/ Distance from lourdatior. 4Q.._.._....Moance to neons:►lot line. .7 O <br /> Numm bs. ng <br /> yFof lines. .... I Loth of each line 57—. ._Width of trench 3i(:. <br /> �T of f Iter material. Jq0 C Dooth of ;iter v+ater;al 1,�'�!,-Total <br /> Seepage P,t: 3nstenca to nearest well S� Odtanca from foundation LQ._...Distance to nearest tot lira r? fi <br /> Number of pits .�-- `iping metaral.,RD�x.....Sats: Diameter /J7. / Oep•h r5� <br /> Cesspool: f Distance from nearest T+eU Dittenee from fayndation Linaig marerio!. <br /> r <br /> Sisi: 8iemshr Depth....__........ ........_.. ._ ......Liquid Capecity gait. <br /> "p•,y: Onfence from nearest wall Oistence from nearest building._.._. .......,.......... <br /> . . <br /> ❑ Distance to nearest lot Gne_. ,. <br /> Remodeling and/`r p,iring idaurSa):. ._. ._.... .. .. <br /> _..�. _.._�,.. �.. .. �.. . ..--.. <br /> 1bereby Corbett tbd Ibis applkatlen sed Heat the wok will be dare &* "cordaece, dM San Awquln County <br /> erdeesseas 3f to of ehi San Joaquin Local He" District. / <br /> beR. � <br /> (Owner eed/or Carrhacfarl <br /> BIT .- --_ . . <br /> (Pb► plan• 7. <br /> dtowYq sip of hsf, "ef s t ii rel:Kers to w db, 4 Mid ngs, etc_. call be pleeed on reverse side{, <br /> FOR DEPARTMENT USE ONLY..) <br /> APPLICATION ACCEPTED BY • r1'. Cl _ DATE :....-.1 - <br /> REVIEWED BY--... _..- .. DATE . . ..-_. _... <br /> BUILDING PER41T ISSUED................ DATE _.. <br /> AMrN:e n«d/a gaarrndetiw: <br /> RSonD s)0(� <br /> FINAL INSPE4tTi9 6 <br /> ..�. SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> t...e w...w«N..w <br /> no w«r oN s..w 134 sr...,...twin 20110010 as lrew <br /> tl.ela.n,GMrww L.• W1.C.Mrrw.l. M«r.c.,CaMe.ne v"w.Gatellrre <br /> res Y -ENSCD a-^-Y xM •i•at ATLAS <br /> r <br />