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~ <br /> FVLOFFICE ��zs��� <br /> p��t �� <br /> --------------------- This Permit Exeires I Year From Date Issued <br /> �/ ��������������� F���t S�������TI���� PERMIT ^--�--' <br /> ^ - Dm Du+m |o�ed �'-/.�-�l.��x <br /> " � <br /> pm� herein described. <br /> App `"^~^ '^ ^ '--/ - - o the �" J ' Local Health District for* permit to construct and install the <br /> This application is made mcompliance with County Ordinance No. 549. <br /> ' � - -_--_-_ <br /> JOB ADDRESS AND <br /> / <br /> Owner's Name__' <br /> 7.' <br /> i <br /> / Add <br /> i - -�----'------ ' <br /> '-'----.-'---_--- - Phone_--_------ <br /> � ............ <br /> �o?rn=��,o Name .�y <br /> ' <br /> �� <br /> C�6m, <br /> Installation will serve: Residence � A��� H�� O Cn�mn�� [3 Trailer Court E5--M _ <br /> Number of living units: ---f. Number ufbedrooms ---J- Number of baths Lot size ....................................' Water Supply: Public system � �° ^^ ~^'/ ,ystnm ] PrivatwLJ Depth to Water Table 6^m' ff. <br /> .'' <br /> Character ofsail tow --u'" of 3 fee+: Sand E] Grave| U- Sandy <br /> Clay Loam C1 <br /> Clay Adobe - <br /> 'dpmn [ <br /> ^/ N�w Construction: Yes ma~IN-p [3 FHA/VA^ Yeu [] NpM- <br /> p,wvi000 Application Made: (if ye,'6o�� - '�) No4�2- <br /> TYPE <br /> OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool* n+mm if <br /> public *ew*" ., available. _--. -_ . <br /> Ja <br /> Septic Tank: o'mn from nou"=. Distance � '� <br /> - ' Size C <br /> nc� fr�m fnu 6 ti n. � Distance to neu,w* xa~t'^^n-�m' <br /> '�^'.'-_.-. <br /> Disposal 'ie|6' D|,�unc� from neara,� ~uQ���� -_Di,tu --- <br /> _ <br /> � -'--'. Vi6t6 of trench <br /> m~e~ Number of |in ���� L*ngfooucno�u| � <br /> Type of fiKn, muto,�- mw���.-'-De�h of fiKv, mut �--_7o+a| length � ____- <br /> ' � <br /> � <br /> Seepage piCxdmnco to noa,m, well - Distunc= fn,� foundation' Distance to nearest lot line.................. <br /> u/ - �z*. D|u��+a� _.Depth----'----- <br /> Number ofp�,'- Lining mu+en -'_-' <br /> --Lining mutariui <br /> ..................................... <br /> Cesspool: <br /> Cesspool: Dist nce from nearest well ' Dbtuncafnzm foundation------ ----- <br /> 0 Sbw� D�mmt�c -'--_'-_'-_-,ep, _---------- --------------- -----------------Liquid Capacity------ <br /> ------------- <br /> Distance neo�� w*K --_-_'------'D�tunow fno� nn*o�t6vi|6ing-'--'----_--_- <br /> Pr�y� _---_---- <br /> --_'-_----'---'-----'-- <br /> ! Didunca +onearest lot |inw--'-__.-_------- <br /> ------ <br /> Remodeling and/or repairing (de~crU,e :---___-_.-----___'_------___.--''-------'--'---'-- <br /> ' � ___________.___-_-_- <br /> _ <br /> .____.__________-_-----'--'---''-----'--'-'--'' _ <br /> ---------------------------------------------- <br /> � --_'_-'_____._--'-----.-_____- - <br /> .-�- __--_-._-----_.'- __--_____--_.___-_---__-'------__-_--- <br /> � --------'--------'' ----thattho workwill be done in accordance with San Joaquin County <br /> I hereby certify that I have prepared this application and <br /> I Health District. <br /> ` ~..a..e- State laws._ . <br /> ` ~ ' -_-''__.--_----�/���-'--------''_-----�--� <br /> ---- - 6w u��m� �n rm��rmm ��m� - <br /> =Y~-------' ���� �r ,m�f�� fm ���` �w�6�gv mfc~ cmn ,' . <br /> 0� �� ��� �� � l� �w�n � ��m =` <br /> FOR DEPARTMENT USE ONLY <br /> ` <br /> ~~.~-.N- PERMIT_ �--' _-_--'__'-_-'-_� <br /> ' <br /> Alterations and/or -_-.----.-'-_-----'--'---_______.___._______'-_----_._- <br /> '--'----'--------'----' <br /> -_--'-_'_''-'--_-''_-' _-'---''---_--- <br /> / -'-_-__._-.-__-'_-_--_-----------'_.__-_--'--_-_-_---'-- ._ -_-------_--' <br /> __-----_---.----'_-_----------._---__-----_-_''- ��--� .---'-'---''_--_� <br /> / _.--_----_----_-'-_.--'_----'--'_._----'''_''''-''- <br /> | -1 Duto ��� �--_-------- <br /> FINAL INSPECTION BY�'_,�� --- -�~�~--'-_-- <br /> ' �� ��N �C����U|NLC���LY�G��THDISTRICT <br /> 130 South Amerkanotreet 300 West Oak Street m*sycamore Street 20S West 91h Street <br /> Stockton,California Locl/.m"xfornia Manteca,California Tracy,California ' <br /> m , "m""o, "-a, v* "°. ATLAS <br />