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� <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) <br /> Date |ouo .- <br /> 6 <br /> . ' <br /> Application is hereby mo6o to the Sun Jouquin'Loco| Hvm|fk District for o permit to construct and install the work herein described. <br /> This application is made in compliancewith County Ordinance <br /> Owner's Name <br /> Installation will serve: Residence X partment House E] Commercial E] Trailer Court E] W Mote�l -Df] Other 0 <br /> Number of-living units Number of bedrooms ---c__3 Number of baths Lot size <br /> Water-Supply: Public system`4E] Community system L] Private [X, Depth to Wafe. lable <br /> Character of soil to a depth o!'f 3 feet: Sand 0 Gravel El Sandy Loam El Clay Loam [] Clay E] Adobe Hardpan <br /> Previous Application Made: ,Yes Ej No X New-Construcfion: Yes E] No FHA/VA-. Yes [j No <br /> TYPE.OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or'cesspool permitted if public sewer is available within 200 feet.) <br /> an F <br /> Disposal Hild: Distance from nearest wet_-50f-Distance from f Coundafion---- -------------Distance to nearest lot line---too_�� <br /> Type bf filter material---�5f-�fql <br /> ' ------------------------ <br /> Remodeling and/or re pairing (qesc b ) ' 4 ` <br /> I hereby certify that I have prepared fhis application and that the work will be done in accordance wA San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> p/gnnm/ -------------------_-..r.'--.-..yOwne, anu/or Contractor) <br /> 8v:' .--.-_.-1�_-,-,-�--_---_------------------.--(7�v)--------.--_--------`--- <br /> /P1of �mn.�now�go�enflot |ocmti*n'of ,ystemin relation fowells, buildings, ef*.' can boplaced onreverse sidnJ' <br /> 7 <br /> FOR DEPARTMENT USE ONLY <br /> ° <br /> APPLICATION ACCEPTED BY' D/�TE------------------------------------------- <br /> REV|EWED B\-------- ---------------------------------- <br /> BUILDING PERMIT ISSUED--: '�' ------ <br /> Alterations" <br /> Alteru+ion� unJ/nr ,wcnmmend mions:-------------------------------� <br /> -------------------------------------------------------------------------------------------------_-------------------`- <br /> ' , <br /> -_----_.---''-'�--_.'''--'~__-'�--------------- �---'-_'-_-'-__'-'-,-'-_-.'''_-''-__-__''__._-_.'_-. <br /> � <br /> .-_.----.-'_-'---_---'.''--'-'--''''-'-'--_'--'-'-_-''__.�'_-.-''_--''--'''--_-_--'''_--''_-._-'--- <br /> ' . , <br /> ----------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> ------------------------- -------- --------- . ------- -------- --------------------------- ---------------_�--__---_.. <br /> , <br /> 7_77� <br /> F|NAL |N8PECT|{)N 'QY�-�''�*�_.��. Dm+;''',c--',�- -'_-'--'-''- <br /> SAN J[AQ0N LOCAL HEALTH DISTRICT <br /> /30 South Annerica" Street 300 West Oak Street /32 Sycarnore Street ow North "C" Street <br /> s+=kt"^. California Lodi, California Manteca, California Tra^v. California <br /> sn--9-2w ' x°./"°v 1.57 F,p.00. . <br />