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f <br /> APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION------------------------': ------------------------------------------------ ------ -------- <br /> [-I <br /> 1�1 <br /> Owner's Name---------TZ4 f--j_a_:,�_e--------------------------L----•---------------------- ----------------------------------------------------- Phon -------X33923---- -------- <br /> r r <br /> Address--------�-- 0:�---1�'�'-�='----���--_-�--------------------------------- ---------- - --------- ------- ---------- - - --- ---- - ----- ---------- - ---------------- � <br /> -Contractor's Name-------leu_�•_0,-------------------------------------- r <br /> � --- ------ ------ Phone -�--'�9��-- -------- <br /> Installation will serve: ResidenceZ] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> 2 R 1f <br /> Number of living units: ® Number of bedrooms E]2 Number of baths [ Lot size-----s-__u __>___-___- GS-------------------- <br /> T Water Supply: Public system ❑ Community system ❑ Private [�p <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe M Hardpan ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> Septic Tank: Distance <br /> tank Distance f oml Pear e�>IL_45-hc sewer lewithin 200 o <br /> Distance fromfoundatiion _{1Q <br />