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� <br /> ' <br /> APPLICATIONFORSANITATIONPERMIT Permit No. ----- <br /> (Complete in Duplicate) Date Issued �17.1 .. <br /> � mude to the Son Joaquin Local Health District for opermi+ +ncon�� . and install the work herein described., <br /> This <br /> � applicationis madein comphanceXithCounty Ordinance No 649 <br /> Installation will serve: Residence X Apartment' House E] Commercial Trailer Court E] Motel E] Other E] <br /> Number of living units: --- Numbbr of bedrooms -;-'-Number of baths Lot size ---- <br /> Water Supply: Public system [I Community system El Private)�i I De t o Water Table -IL <br /> Character of soil to a depth—of 3 feet- Sand E] Gravel [] Sandy Lo.am [:] Clay Loam E] Clay E] Adobe Hardpan <br /> Previous Application Made: Yes 0 No X. New Construcfio�: Yes Ej Noo hxw�, <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Disposal Fiel D�stance from nearest well-_5'47A�._Disfan�e from foundation--, _-Distance to nearest lot <br /> Seepage Pit: Distance to nearest well----------------------Disfance-from foundation--------------------Distance to nearest lot line----------------- <br /> ' ---------------------------------------------------_—_—__..--.—_.--.--._--_—��.._—..__...___.---_.__—_-----_—' <br /> . � . <br /> '—''—'—'_'''-- ----------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------- <br /> > h*,e6' U H <br /> at | 6mvu p,wpo,o6 +��, application and +6o| the work will a��nr6anma � h Sun Joaquin County Y <br /> ordinances, State |a*,. and rules and regulations of the SanJoaq6in Local Health District. <br /> �� --------- <br /> ' �� '"���/'—��—'*�- '-���--`---------'-----_---_^--------.---- and/or <br /> -~ /T��� � <br /> ' --�—������� -m,�f�m4a~w�Uw6u�6 - " side)~~~^�=�� <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY — c '—'---'—''---''—'''—''— DATE'--'—''—'--''—''—'--'''' <br /> REV|EuVBD BY--''--''—''^''----'-- <br /> BUILDING PERMIT |3SUED—_—�-------...a��..���-� --.--.-----. DATE-------------------------------------- <br /> Alterationsand/or ---------------------------- --------------------------------------------------------------- _------------------------------------------------------------ <br /> ------------------------___________________________�___________________________________________________' <br /> ` <br /> ---''---'-------'--' <br /> _ ....... <br /> - ����������f����c��^ ��----.-----.---.—_-------------------------------------------- <br /> ----------------- ------------------- --------------------- ~ ----------------- —''—''---'�—'--------'—'--''— '--. � <br /> F|N/\L INSPECTION BY`----- �r�o��- Date--------�----..�-------..��^—__—. <br /> ' �~�-� <br /> SAN JOAQU|NLOCAL HEALTH DISTRICT <br /> /30 South Americ�an street 300 West Oak Street /32 Sycamore Street 814 North "C" Street <br /> Stockton, California Locl|, California Manteca, California Tracy, California <br /> "S_"_"" `^=°^~,~""" 12.S4 <br />