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~ " <br /> � FOR OFFICE APPLICATION FOR SANITATION PERMIT <br /> Permit <br /> (C*mp/�einT6wU*awN <br /> This-PermitDou, |s�ueJ —.�..�|_��—�� <br /> ' <br /> Application hereby made to the Son Joaquin Local Health District for o permit to construct and install the work herein <br /> oear/oeo. This application i, made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> JOB ADDRESS/LOCATION <br /> _ / <br /> 61.~' 4/ <br /> — J _._ ------'_'--__ _City <br /> ~~ ----------------------------------- ........�'—' <br /> Contractor's Name L/oans* #� r3f� —.— P6unn..� License <br /> � <br /> Rosi6ence;0 Apartment Houoef� Commercial OTraJer Court :17 / <br /> Motel EJ Other .............. . .......... <br /> _____ <br /> Number of living units:—'/—' Number of bedrooms .......... * Ghn6o, ---'' Lot Size ........ <br /> ........ <br /> Water Supply; Public System and name/ _............ ..................................._---___-----_'-- ------------- Private <br /> �� <br /> Character pfwoi| ^padepth of8feet: Sand <br /> 5e' 0}t[] Clay [] Peat D Sandy Loam [] Clay Loam <br /> Hardpan 0 A6o6eL7 RU Mau^dn| ' '—' �fyes type _ ................. <br /> (Plot �Ian, showing size of lot, location of system in relat ion to wells, buildings, etc must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 260 feetJ <br /> PACKAGE TREATMENT [ ] SEPT|CTANK{ } 8izp--'--___--'--� — Liquid Depth <br /> Distance to nearest: Well <br /> ilt <br /> th <br /> pth <br /> e/.. F n all <br /> Di | | � <br /> [Draw existing and required addition on reverse side) <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin <br /> County Ordinances, State Law— and Rules and --°--'~~~ ~' '"~ ~~^ Joaquin Local ~e=° � Home the <br /> signature certifies'I certify that in the performance of the work for which this permit is issued, / shall not employ any person in such manner <br /> as to become <br /> Signed —_--- Ovvner <br /> By -------- ' J��)e -----_—_-----________^--'--' <br /> (If other than owner) <br /> ' <br /> FOR DEPAtTMENT USE ONLY <br /> APPLICATION ACCEPTED By <br /> Final Inspection <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> E. H. 9 l''6ORev, 6M <br /> _ <br />