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FOR OFFICE USE: r <br /> 15 41?,-T- J_ Of-- 3 S ow—) <br /> -- --------- P APPLICATION FOR SANITATe PERMIT Permit No. _A.T,.2.y <br /> ---------------------------------------- <br /> --------------------------- ...........I.................. Dat;i;7 <br /> ...................__............ ................ This Permit Expires I Year From Date Issued 2- <br /> OF <br /> Application is hereby made to the San Joaquin Local Heal+h District for a permit to construct and install thq_work herein described. <br /> This application is made in complianqjLwith County Ordinance No. 549. L;Se-ALON <br /> ZZC <br /> JOB ADDRESS AN6­16CAilON - - ... <br /> xarw <br /> tit <br /> Owner's Name ..... s --- .. ..-- - ,. Phone._..._......--- <br /> ................ . . . . <br /> Address......._32.0...... ........... TV....---..._..---...............­........................................................... <br /> Contractor's Name..m4z..Do kt!" ANK�-:--------------11--- —3_5001?,�7 <br /> ...... .%nc .......T --- ..... PhonA. <br /> Installation will serve: Residence k"Apartment House [3 Commercial,o Trail Court [] Motel [3 Other El <br /> Number of living units; . Number of bedrooms y'.. Number baths . Lot usize ........................ <br /> Depth To Water Table 5. ft. 4L. <br /> Water Supply: Public system ❑ Community system 0 Privis = <br /> Character of soil to a depth of 3 feet: Sand Gravel E] Sandy Loom 0 Clay Loam Table <br /> ❑ Adobe[3 Hardpan [I <br /> A 0, <br /> Previous Application Made: (If yes,date....................) No grNew Construction: Yes ja--<o E] FHA/VAi Yes E] No q <br /> TYPE OF INSTALLATION AND SPECIFICATIONS!—. <br /> (No septic tank or cesspool permitted if public sewer is available within 100 feefl <br /> "Septic'Tank: Distance from nearest well...5.01.1.61staa6p from gr <br /> jpupdation.... M I C.QN 1� <br /> III... .. $,- <br /> No, of compartments----;;;9!-.............Siz,5.. .,--.Liquid dep;... ...... Capacit 1;), <br /> % <br /> Disposal Field: Distance from nearest well.5 Distance from foundation... ........Distance to ne6rest,lot <br /> Number of lines......./.....!�.................Length of each line....... Width ............... <br /> --Type of fiTt;r material--. .. ..CJ.d,,.,-Depfh of filter m I aterial..... '.'Total h length--------------24.................... <br /> S, Distance to neatest-welI71.1610i......Di%ince from f�undaflon._�_10:. t to nearest lot line...... <br /> Number of pit. Diameter-30.._-------Depth.10.................... <br /> VC I .# VV 701 <br /> Cesspool: Distance from <br /> nearest well.................Distance fromYoundistion....................Lining material.........................._..._..... 0—e <br /> 0 Size: Diameter............ .....................Depth..................................................Liquid Capacity...........................gals. <br /> I <br /> Privy: Distance from nearest well........................... H ........Distance from nearest building.......__...-....._........_......__.... <br /> Distanceto nearest lot.Iine:t.-.. .=..................................................................................­­..............._............... T <br /> 4— <br /> Remodefing and/or repairing (describe):................................. ............ .................................................................. ....................... JE <br /> ................................................................................................................ ................ ........................................................... <br /> ............................................................................................­.....................I.......................................-.1.41......................................... V <br /> ------I-- .... <br /> .... . <br /> -- _--f---I­ - _--------_ .... <br /> --... -- - --- -- -- - - - - - -acc - - -- - -- ---. a-qu _- - - <br /> hereby certify thahav9 prepared this applieationandthattheworkwill be doneinordincewith SanJoin County <br /> ordinane". - <br /> State laws, and rulespiII4 regulations of the an Joaquin Local Health District. <br /> ........... iiWor Contractor) <br /> ---- ---- -- <br /> ............... ................... ..........................................- ----------- <br /> By <br /> ---------- <br /> BY ........(Title).........1��_,*- <br /> (Plot plan, showing size of lot, location of system in relation to wells. buildings, e+c., can be placed 16n reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY...7_r4.-RA_0..t.................__........................................... DATE... ...... <br /> REVIEWEDBY......................................................................................................................... DATE............................................................ <br /> BUILDINGPERMIT ISSUED.._........_.................................................__................................. DATE.......__............. ._..._........................... <br /> ANrafionsand/or recarnmencrations:......................................-..........................................................................................................•............ <br /> .............................................................................................. ..........I............................................................................................................ <br /> ..............***.....*......... ........... ..........."',­,",.....................*...............**....*............­...*,-**'*....**.........**....­­...... ......- <br /> ...................... . ... . . .............. .. ..... ............................................................................................................................. <br /> ..................................................-------- .......I....... ------. ........ . ............................. ........................ ................................................... <br /> FINAL INSP <br /> ................. <br /> ... .. ....... <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 So.th America.Street 300 wee Oak Street 124 sycamore street 205 West 9th Sireet <br /> Stockton,Colif.rrld Loan,California Manteca,California Tracy,California <br /> ES 9 REVISED 8.59 2M 5-62 ATLAS <br />