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� APPLICATiON <br /> ��� ��� �T � PERMIT Permit No4 -� <br /> � C�m� -a�\ <br /> . r~~^'r'~'~ -- ' <br /> Date Issued <br /> 2-/ 3'0_0 J(�' <br /> Application b hereby made to the San Joaquin Local Health District for u permit to construct and 'install the work herein described. <br /> This application is made in compliance with County OrdN <br /> 1-1-01 ' L" <br /> JOB ADDRESS AND LOCATION---- <br /> kk <br /> ---------------------------- <br /> ------------------- <br /> Installation will serve: Residence �2- Apartment House Commercial F] Trailer Court E] Motel [] Other E] <br /> Water Supply: Public system E] Community system E] Frivate RR'-Depth to Water Table _�K ft� <br /> Character of soil to a depth of 3 feet: Sand [] 6ravel E] Sandy Loam �_ Clay Loam E] Clay E] Adobe [] Hardpan E] <br /> Previous Application Made: Yes 0 No �!r New�,Q- -"N o El <br /> TYPE OF INSTALLATION AND SPEC I F16ATIONS: <br /> (No septic tank or cesspool permitted if pub lic sewer is available within 200 feet.) <br /> k -_size 291 ----Liquid dep�h------.3---------- Capacity.P.7------- <br /> Disposal Field: Distance from n'eardsl welI__6..6_1_"'�_Vstance from foundafion__A_fti1...... Distance to nearest lot line----------------- <br /> Type of filter <br /> � Seepag Pit: Distance to nearest e� � Di tvnce f om .�ound +/on- _11-1H ~'D; tunce to nearest lot line- <br /> id <br /> �. _-_ - --_� - --� <br /> Privy: Distance from' nearest�weU-_,------------".� g ---- <br /> �O�otunce�f�o� noona�+ �ui|d�n .�/ . <br /> � [] Distance to nearest |ot |�ne ----- ------------------------------------- -------------------------------------------------------------------------- ---------- .. <br /> ! Remo6e|ing and/or repairing (describe):_ '-'''-------'__________ <br /> '--'-__._-------._-----_-___-__--____._��-_»-_--_-._-_._-.__-----'_..'^_---,-~ <br /> . ---.-_-_.-_-._ ------------------------- <br /> ------------ ------------------------------------------------------------------------------------------------------------------------------------- <br /> ---------------------------------------------------------------------- ________________________'__'_______________,^__________________ <br /> that the work will be done in accordance with Son Joaquin County <br /> ordinances, State laws, and rules'and regulations of the San Joaquin Local Health District. <br /> ' ( "y'=°)-- '-^-� ~�-*���----------''�-------r------'�����" -` �' Contractor) <br /> . ~�� � <br /> (Plot plan, showing size of [of. location of system in relation"io'w'e:Ils,'9�ildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION-ACCEPTED -BY-.---- <br /> RBHEVVB} 8Y--'' � u^/�� <br /> | <br /> BUILDING PERMIT ISSUED----------- <br /> ur`/E-----_���� ------.-_--- <br /> Alterations <br /> ` und/or ,econmen6aGmrns;'-------------------_-.----------.-�---- <br /> ---_.-----.---_________. <br /> ---_---_------_-----_----------..,-----_--_-_--_----_----____---__-----. <br /> -'-'''-'''--'---'---''--'-'-''-'--'---''-''''-'-'---''--''''-''-'--''----'---''----------'' <br /> .-'-_-'--''-''------'''_-'''-''''--'---''-'''--'''-_''_--''--_ -'--'''-'''''---''-''--'-'''-_ <br /> ---- - '-'''—'''-''''-'''''---'-''--'-'-'''-''--'--'''''-'-''-'''-''''''---'-''--'-''--'-' <br /> L �FINAL�L INSPECTION BY�'''' Do+o-''-'� fo",------ --'-'--'---_--. <br /> SAN <br /> � <br /> JOAQUUN LOCAL HEALTH DISTRICT <br /> mu Sv"m American Street 300 West Oak Street /o Sycamore Street ' ow North ^o^ s*"o <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> ES-7-2M /o,c x"viseJ vv-2100 *' ~ <br />