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livingAPPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) <br /> ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> h�ispiacnpaoptlication is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION------ 5/43 R_ ....._ __ aoty)------_­---------- <br /> Installation will serve: Residence �Z Apartment House Commerci�l E] Trailer Court Motel 0 Other Ej <br /> Number of <br /> ----7-------------- <br /> Water <br /> | <br /> Wate, Supply: Public system El Com pthtoWater Table %?47ft. , | <br /> Character of soil tomdepth of 3 feet: Sand E] G��| � -SF���m � Clay Clay E] /�o6e�� Hardpan E] <br /> ' � <br /> Previous K1a6e� Yo� [� N� N� Ne. Con�r Construction-. Yes kA No �] � <br /> . . -_ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (N� septic tank m, uoompnn| po,mKfn6 if sewer is available within 200 feet.) <br /> . <br /> ` <br /> � S +iTank: Distance from noon,,t well-- Distance from fo ;on ka Material <br /> Disposal Id: Distance from nearest v�ell......r-0-4 Distance from foundation------;;tii_!---�.Di-istance6 nearest lot Iine,,,rX.__. <br /> Seepage Pit: Distance to nearlwelt-mw----------------Distance from founclafio-------------------- f <br />� Privy: Distance from nearest well------------------ --------__-------------------Distance from nearest building---------- -------------------__-------- <br /> 'ElE <br /> nDistance to nearest 4------------------------------------ ---------_---------------------- ------_------___________.- <br /> | <br /> [ <br /> Remodeling and/or repairing (6os:riSe):_'-.---,��_-.---_-__-__-_-'--�_._--,_._____________ <br /> x <br /> -'-`._-_____._-_--__._- '-''-__--_.-'__.-__-'''___'-_.-''-_--_-_'-''-'''-''--'-- <br /> --..� ---------------------------------_--.�. � ''---___-----_--__---____ � _--''_.___-----._---. <br /> _ _'` __.________.__). y -------------------------------------------------------- ----------------------------------------_______.__.____ Y <br /> I hereby certify that I have prep6r�d this application and that the work will be done-in accordance with San Joaquin County <br /> ordinances, State laws, and rules and,x6gulations of the San Joaquin Local Health District f. <br />' pg'=" ---L+~°" " '-----------'----''`--- and/or' Contractor)— <br /> By:-------------^---'---'---�-'-'---''�'--'�''--'''--'--'---'----''''` ''r'--'''-'--''''-�--'�-''---- <br /> /P1ot cJmn, showing size of lot, location mf" system in relation towells, buil6ing«, o+c., can b� nlace6 on reverse side). <br /> ^ <br /> FOR DEPARTMENT USE ONLY <br /> REVIEWED BY-------------------------------- - ----- P5­1 <br /> , <br /> BUILDINGPERMIT ISSUED---------------------------------------------------------------------------------------------------- DATE'-''-''----''-''---_''_''_-'- ' <br /> '',--.--' - ---.. .. ------------- <br /> --------------------------- <br /> - <br /> - <br /> � <br /> /f�=' �,_^~_`y_.______` _________ <br /> �~^ ��~-~~~~.�` ''__ <br /> _ _--_ _--�--��-._---.-'_---._-_--__-_-_� __-_--__---' <br /> ''-'--'---'—''''--'—'''''^---''---''--''''-'''--'''---'---''---'''-''''----'''-'''-''--'--'--- <br /> -''-''-'--�'-'''--'-'''''--''''-'''---''-''''---''--''''-_''''-''''--''-''--'__''-'--.-''--_-, <br /> ( <br /> F|N~�L |NSPECT|[)N 8Y:-.r---�.��%v���L�-------.. Duov-.��-K-��---.163--�.- ------------ <br /> ^ SAN JOAQU|NLOCAL HEALTH DISTRICT <br /> /30 South America, Street 300 West Oak Street /32 Sycamore Street ow North "C' Sfriet <br /> S+" w"". California Lod{. California Manteca. California Tracy, California <br /> ~_ <br /> ES-9-2M /0-52 n".�svJ vv-2/00 <br />