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FOR OFFICE USE: <br /> --- ----------- --- <br /> I�---._ APPLICATION FOR SANITATION PERMIT Permit No. <br /> ------------------------------------- .1M----- (Complete in Duplicate) J <br /> ------------------------------------------ This This permit Expires 1 Year From Date Issued Date Issued _____ ._ <br /> Application is hereby maddlto the San Joaquin Local Health District for a permit to construct and install the wo`rk`he-rein described. <br /> This application is made in compliance with County Ordinance No. S49. <br /> JOB ADDRESS AND LOC AITIN 4 �14------ ----- <br /> llf - - <br /> Owner's Name-------- -- $F +�-----•----- ------------------ ------------------- - -------------------------- -- ------------- Phone-_-------------------------------- <br /> Address---------- <br /> ------------------------------ <br /> Address----------0.1!Aas---- --------------------------- <br /> Contractor's Name------ - -- - - `y -------------------------------- -•---- --------•-- •--- ------ Phone------------------------ ---------- <br /> Installation will serve: Residenceartment House ❑ Commercial ElTrailer Court ❑ Motel ❑ Other ❑ <br /> Number of living unis: _ -_ Number of bedrooms__ Number of baths .^__ Lot size --___________________ <br /> l <br /> Water Supply: Public system ❑ Community system ❑ Private Depth to Water Table _400:rP4f. <br /> Character of soil to a dept l:of 3 feet- Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe[Hardpan ❑ <br /> Previous Application Made.l�. (If yes,date_---- <br />