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FOR OFF <br /> Permit No. A <br /> 2.7-.- A6�------- ... ......... SANITATION PERMIT <br /> K <br /> APPLICATION FO 0 <br /> ........................­........... (Comple4e.in Duplicate) Date lssued-,5�f� <br /> .............. x re a- <br /> -T s it E' c�i I I Y ar ;r.. Date Issued. bed. <br /> Install the work herein described. <br /> M,d,`�the San Joa uin cal Health Distritt for d permit to construct and <br /> Application is her Cou4ty ordinance No,�:549. <br /> This applic6tion I Rd. <br /> i ado in compliance W*1' <br /> .................... <br /> 7 ..................... .... . ............ ....... <br /> ION--- ---------- -1--------- Nf Phone... ....................... <br /> 1. ­­­­ <br /> JOB ADDRESS AND L000 f"-- <br /> ..... .......................... "j. <br /> Owner's Name--..... ............. <br /> ................... <br /> Addr.,­­­..3.-.f A. ............ ............ <br /> ..,.!............­­­­­. PhQfte-.......... <br /> ---------- <br /> Contractor's Name-........... ----------------------------------------- ei ❑0 Other 0 <br /> R idence ['Apartment House Cj Commercial 0,;' Trl!`;�er tov4 0 M"� <br /> 1(� 4470-1/ 1 <br /> installation will serve: �si�, ­- ------ <br /> -nbdr of baths­ .X.-147k <br /> Lot <br /> Water Ta <br /> Number of I'M - uni Number of bedrooms <br /> DBP We;, ft <br /> C3 Community system'C3 Private D Ith to <br /> Water Supply_ <br /> pu .I system Adobe H&dpan <br /> Pu Clay[I <br /> Lba <br /> Character of soil a dep+h!of 3 feet' Sand [I Gray.01.0 Sandy Loam ' "�-r] FHA/VA: Yes❑0/No❑ <br /> 1/0 ion: yes,L] N <br /> Previous Application Made: kif yes,date-------1-.......... ) No Er-­New Construct <br /> TypE OF INSTALLATION AND SPECIFICATIONS: <br /> tank or ceispool permitted if public sewer_is ayailable.within 200 fee <br /> ------------ <br /> (No septic I Material..-- <br /> Ce from foundation <br /> -a ncetfrom nearest welirt Distance. Capacity...... ------------­- <br /> Septic Tank: Dis', ......... .. <br /> No. of compartments. brie-Distance to nearest lot Ii <br /> Distance from foundation-Z. <br /> Disposal Field: Distance from nearest well�. ngtk of each line_..._-... of trench................. ...... <br /> Number-'of lines.__.._--.---_..,...._-....--------Le <br /> of filter materiali---------- ...........Total iength­.........11......................... <br /> Type of.:iilter material­­­­..........Depth <br /> on...... Dista rice to nearas+ lot line.._:...._ <br /> nearest well ....Distance from foundation .........-­------- <br /> Seepage Pit: Distancg'to n .................. Size- Diameter--..............­­Depth------­.. <br /> Linling material....­­­­....... 1. <br /> N❑ umber Of pits-----------­------ Lining material........................-------- <br /> .......... Distance from founda+ion.-­1' <br /> Cesspool: Distance from nearest well <br /> -Liquid Capacity....................------gals. <br /> Size: Diameter.- ------­­-­-------- 4 ---r_.__----...... <br /> 0 <br /> Distance f1rorn nearest building., - <br /> Distance from nearest weft... -- -------- .........­---------- <br /> Privy: to neares4, lot line........„w............... .................. ----------------- <br /> --- <br /> --------------( <br /> ❑ Distance 4 .....74 ------- ----------- <br /> Remodeling and/or repairing (describe};.__._ ------.............................I.................. <br /> ------------- ---- <br /> rCt <br /> .............. <br /> --------------- <br /> ---- ------ ---­--­------ <br /> eyl ct <br /> ---A;03 <br /> .................... <br /> -------------f­­­.......... ......................... ----------------- -----­------ --------­------------- <br /> rtify that 1.have prepared this application and ihat the work will be done in accordance with San Joaquin CountY <br /> I hereby Certify laws, and rules and regulations of the San 3oaquin Local Health District. i - <br /> ordinances, State ;r and/or Contractor) <br /> ...........................(Owne <br /> --------- <br /> ..........,/................. 4-ra,161.................... ...............I....... <br /> By:................ w , build;ngs. etc., can be plated an reverse sidal. <br /> size of lei- <br /> r location of system in relaflioin to <br /> (Plot plan, showing <br /> T Ustbkv, <br /> FOR DEP'A <br /> -------­--­ ------....... <br /> APPLICATION ACCEPTED BY--..---,. ........ <br /> --- DATE-----­------------------- <br /> REVIEWEDBY...................... ............................ DATE... ......../--------------------- ........... <br /> i 'BUILDING PERMIT ISSUED,—'. ...........................1 '.4 <br /> ------- ------ <br /> nc, <br /> qn.d.fio's.­ <br /> Alterations andor recomm <br /> .e <br /> V­. el. .... . 17, r <br /> z <br /> Zjr <br /> ...... ........ <br /> --­---------­---- <br /> FINAL INSPECTION BY:..--_- ------- Date,.._.._.__ <br /> ----...........w._.. <br /> 14 ZUIN LOCAL HEALTH D)STR' ICT <br /> ^04_. k- _. -4% - .4 <br /> 124 Sycor�air#Str"' t 205 West 9,h Sf,e-I <br /> Hazolion Ave. 300 West Oak Stroet monloca,California Tracy,California <br /> Sfixitton,California Lodi.California <br /> E.H.9 2M 1-67 vongwovd Press <br />