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16 �j���|���T����� F���� S�`����kTI���� PERMIT Permit .�-���-_ <br /> ' in �wnkcate ^ <br /> r~~'r~'~ -'--' Date Issued <br /> - San Joaquin Local Health District for o permit to construct and install the <br /> ~ work herein <br /> � described. <br /> This application is made in c ompliance with County Ordinance No. 549. <br /> Phone <br /> . . ^ ._ , <br /> Add <br /> Installation will serve: Residence Apartment House Commercial F] Trailer C6urt E] Motel E] Other E] <br /> Number of living units: __/--- Number of bedrooms AX__ Number of baths --/-- Lot size ---------------------- <br /> Water Supply: Public system Dj� Community system E] Privafe'E] Depth to Wafer Table <br /> Character ofsoil fwm depth nf3 feet: 5un6 [] Gravel [] Sandy Loam E] Clay Loam E] Clay Auobe_�T' Hardpan E] <br /> Previous /�pp|loa�o"��aJe: Yes []n Construction:No��' New Construction: Ye` �� No F] ` � <br /> . . - <br /> . TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> | (Nn sopfh* tank orcesspool ll^ermiffed if publicAwer is availablewithin 200 feet.) � <br /> Septic Tank: Distance from neo,es+ well Distance from founclation-/101-- ,w <br /> «�^ Wo. ofcomportmont,...�''^ ..---Size-jr ' Liquid ---e--- <br /> Disposal' ' Field: Distance from rust wellDistance from foundationDistance to nearest lot ||no` <br /> ! El Number- - lin-------------------"t' <br /> � | <br /> Depth of filter Tot | length SPit: Distance to nearest i ~ .~~.~. ~. line <br /> -� � Diameter ,� � o pm �� � --- <br /> Number of pits ' <br /> ------------------------- <br /> 'i' � � | .,| <br /> FT <br /> ' <br /> ~~ - _. <br /> �amo��ing and/or repairing /6o~����''�'-' '___''----'--'-'--------''-''-_.'__''''-----'-'- <br /> -_-�-'_-_-__._--__-----.-____'_--_-_-._---.__..�=_--.-__-_--_------_-_--_-.- <br /> ._______._____�_._____�''___'-_---__-_.--'-_'''_-.-_------'--'-'-'--'-'--'--�-''-'�--'-- [ <br /> -----'------------'--'----'----''----------'''---'----''----''-'--'---''--''-''-'--'-- <br /> � that He work will be done in accordance.wifh San Joaquin County <br /> ordinances, State laws', and rul and regulations of the San Joaquin Local Health District. <br /> By: -- ---------------- --------------------------------------------------------------. .�� ~ ' <br /> - . o+w` can �e pm� �/P1o+ p|an, showing s�� o lot, |�naf�m of.syo onin n�mt�nfow��, 6u7|6in�v.�� m <br /> ' <br /> FOR DEPARTMENT USE ONLY <br /> ` 8U|LD|NG PERMIT ISSUED -- DATE------- <br /> and/or recommendations:---------- ------------------ -------------------- ---------------------------------------------------------------------------- ------------- -------------- <br /> ---------------------------------------------------------------------------------'-----_''''-,-''-_-'-`-''---_-'-_'-_-''''--.-_-'------' <br /> '-'--`----------'----------------------'------'------------------'---'' <br /> ^ --'-''--''-''_''---�''_''''_-''''-'-_'''_-`-.-'''-'''--'-''''-'''''-'''-''''---'--'--------' <br /> -`'----'_'''-'-_--''''--'''_''-----''-''''-''--'---'''-'''-�''_'''-'''------''-'-'_--'- <br /> . <br /> ~ ' �� ~�-�� =- �� �� <br /> F|N/\L |NSPEtTON 8Y�-'''' -------------- ---- Date------------*���-''��-''��''-��'-'_--'__ <br /> . . <br /> SAN JOAQ0N LOCAL HEALTH DISTRICT <br /> /30 South America" sheaf 300Wes+ Oak Street ou Sycamore Street m+ worth "C" Street <br /> / ��"��". California ` L"&. California Manteca, California Tracy. California <br /> / - <br /> ES-9-2w /o52Revised vv-2100 � � <br />