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FOR OFFICE USE: <br /> ` <br /> . ._-_-- <br /> ....................... <br /> '-' ----^- <br /> � ........ (Complete-in Duplicate) Date Issued <br /> � <br /> ... ... I This Permit Expires I Year From Date Issued <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. 5 9. <br /> ! -- . -_.--- '.,~ ~~^' <br /> | <br /> Owner's mmmo <br /> 'iL Z�± <br /> 'Installation will serve: <br /> Residence Apartment House Commercial [] Trailer, Courtk[].,Votal El Other <br /> Number of bat[ <br /> Water Supply: Pub ".4. <br /> Character of soil to a dbpfh of 3 feet and Gravel [] Sandy Loam D Clay L�am <br /> Previous A - : -*'\ 1*CI?jy F Adobe �Hardpan <br /> sa :4 Distance fror <br /> NJmber of 1* <br /> Seep Pit, s nce to neares wel).t4e).().......Distance from foundation..../.vf------Distance to nearest lot line---Z W <br /> � <br /> � | <br /> � � - ' - ................. | <br /> cesspool: *oU---_--Db+m,ce 6nm�nun6nhon---''-Uv�g mu+or*L'_-_'-----�_-- ' <br /> --.---_-Dop�.'--_-'---__-'_-_'�.Uqui6 Cuooc�y' �a6� <br /> p�vy: well.................... Distance nearest building_..._-� /c^ ' <br /> nvo,e� �� |�n' -''-'---- ' � <br /> -__ _ � <br /> ` ! <br /> it <br /> Re <br /> vn � <br /> . ' <br /> ' ------- ----v................................... -'--_'.........- ---4'------_-' -----'-__'-_________._______�___ > <br /> I hereby certify that I have prepared this application and +At ---------*------ <br /> )the work will be done in accordance with San Joaquin C*ounfy 1 <br /> )laws, and rules and regulations of the San Joaquin L4al Health District. <br /> \ v . ° � 6e , on reverse w���wy�' '--��r�wn. showing size of lot, location wf�y^�m relation t^ ----' �. <br /> ' <br /> FOR DEPARTMENT USE ONLY <br /> � <br /> DAT <br /> ------'-----'----APPLICATION ACCEPTED � ' - <br /> - °REV|EVED BY'- =�------ <br /> BUILDING PERMIT |CSuED-- � --- '-----'---'-'----' - DATE-- -----------''---- <br /> -'--'' ^ <br /> � <br /> DATE- <br /> Alterations and/or recommendations., <br /> ------------------------------------ --------- ........................... <br /> - . <br /> --------------- - ............................................................................................................. .....................................---_. , <br /> --'--.--'----- 4 <br /> FINAL INSPECTION BY:........... Date............. <br /> -� - ------------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601E.u==/mn Avg. 300 West Oak Street ��omp"�=~m�w, <br /> zu�w�",v,�*,*°' <br /> �"��" California ud/.maw"�� <br /> Manteca,California Tracy,California <br /> recu� i� <br />