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~ <br /> ~ ' <br /> APPLICATION FOR SANITATION ������� Permit No <br /> . . <br /> (Complete in Duplicate) � <br /> #h ��V ���w« � , �� 84&� �� ��� � �� Ww�� ��v� v � w� <br /> ' ' App|ico+i ' ' is hereby mu6o to ���S ~-��a' �n- 2a| Health District for a permit to construct and install the work herein Joxc,ib=6. <br /> , <br /> This |[ fio is madein complianceh County Ord' N 549 <br /> ���� <br /> Cpntructox's Name�---- ------------�=._._..- ---,---.-..,-.----- P6 a,464. <br /> Installation. will serve; Resi4e/nce E] Apartment House [] Commercial Trailer Motel El Other <br /> �~__ ~ X � <br /> Number of living units: '.=Numberofbedrooms .�r, Number of baths ��.- Lot size -_--.-����--.---�.���`�_.`_ <br /> ' *-�� ` <br /> ^ <br /> Water Supply: system: � system ��- <br /> system Commun�� system P� 0v fo Depth �# <br /> to Water To6o_.= ft <br /> Character of soil to m depth of 3 feet: Sand C] Gravel [] Sandy Loam Clay Loam E] ClayEj Adobe - aTbp��[3� <br /> ~ � <br /> Previous a~pp��xca�wn Made: Yes [] No ��' New Construction.' Yos [� No [�� <br /> / <br /> 7yP6 OF INSTALLATION AND SPECIFICATIONS: ' <br /> � ^ <br /> tank or nw��pnn| permitted puWicvow*r�vmvmi�b|ew�Gn 200 feet.)o septic <br /> Disposal Field: Distance from nearest well_.MT"-.�...D�stance iro f 6.n*f-i-.�ip-------2-0.!----Distance 'to nearesf lot <br /> Seepage-Pif: Disfance' to nearest well.AdX_4........Disfanc4eomf undatic,40 -------4f9c,e to nearest ot <br /> ° C*�spoo|� Distance from nearest well----------------- from~fpun6otinn-------Lin|ng mu+erioL---_----.---� \ <br /> [ <br /> [] S�e: Diomnfec--`-----------_,`Deptk------------------ ---------- --------Liquid Capacity----------------------------gals. <br /> Privy: Distance from nuoreutwell---------------------------------- --------------Distance`�om nearest building J\ <br /> ` � <br /> �] Distance to noan,� lot line'------'--''-'-'-'�---'- ----------------------------------------------------------------------- <br /> � <br /> � <br /> � <br /> . RemoJe�g and/or repairing �es �b�--''---'-''--''-'''--_--_.--.'__.'-__.'_-_--''-'`_-'--''-----r-- ~� <br /> y� .__.__.___--_-----.--_.__--_----------_.-'_.__---_--------_----._--_'_-. <br /> '-------_.'-_.---_'__.'''-_------'-_-__.-_.'-_.'_-'--'--.--'-_-___.'''-_----'---_---_.'--'-''''. <br /> ' <br /> '-----'------------''--'------------------------'---'-'---'--'----------- <br /> I hereby certify that I have licufion and that +hework will be done in accordance with San Joaquin County <br /> ordinances, State laws. and rules and regulations of the San Jo�,qu'in Local Health District. <br /> r-� Sgnod)-' X - -- - - - <br /> e- i Z) <br /> , my:_ ..1 -.�/n�����',�:�o*�,-_-._-_.=-.-_'- <br /> ^ P� �a . oltn mao + escan 6* m�� mnmv�e ���� <br /> ' ' ' \ <br /> . <br /> FOR DEPARTMENT USE ONLY <br /> BUILDING pExw1|| ISSUED----------------- <br /> . - �A|hmra�o"o and/or recommendations: -.---------- ------ -. ~ - -- <br /> --------- <br /> _ .. --._ —. -_..''- _-._' -,-_. -__~V_------''--'�� . ._- - -- <br /> 10 <br /> --''--'- - _' - ----'--'—''- ~--'--'--'''-'''--''---~--'---'--'''--''-''-----'-- <br /> r'. <br /> ---_--��---------_-----. �- ----------------.,---------------------------------------------� <br /> _`� <br /> ~ <br /> ------_'--_-. <br /> -----'- --'- - ---'---''----'_ --''-'''-'''-'''-'''---''-'''-''-----'-''-'-----'--. <br /> '11 <br /> RN \L INSPECTION' <br /> 8Y:-..- Do -�.--------.-.. --------- -- ----------------------------------------------- <br /> SAN JOAQUIN <br /> .--_-_.SANJOAQ0N <br /> LOCAL HEALTH DISTRICT <br /> /xo s""m American Street aonWest Oak Street /uz Sycamore Street ' m* m"*h ^c^ street <br /> Stockton. California Lodi, California Manteca, California Tracy, California <br /> ' "°_° `~^~=°""" <br /> '. - <br />