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— APPLICATION FOR SANITATION PERMIT in Duplicate) Application is hone6v made to the Son Joaquin Local Hou|H` Didr�cf for u permit to construct and install the work herein described. This application is made in compliance vif6 County Ordi�ance No. 549. --' A--. - _- . .., �°~~~.^---.~`-_-----_-_-_-.---.------.--.--_` . � � C�"/2J- Owners m --_----------------�--_---------- Phon�.��..-�-��-�- -- ----- -_________ _____---__.--_----________----____._____ �� . Contractor's Name..°�.�^^c'�~-- --_------------------------------------------------ Phpn°_R7xa,�KA------ Installation will oo,vo: Residence Apartment House [] Commercial E] Trailer Court [] Motel E] {}+hvr E] _ Number of living units' - - Number of bedrooms - Number of ��'s. ~ Lot size-jo~ "_ ---'----''-- Water Supply; Public system �� Community Private ' Character of soil to a depth of 3 feet: Sand [-] Gra�te| E] Sandy Loom El Cloy Loam El {�ayEl Adobe Hardpan El � nw TYPE OF INSTALLATION AND SPECIFICATIONS: , (No septic tank or cesspool permitted if public sewer is available within 200 feet.) ' ��Copociy�� izn � �� qu -`=6�=p"=t�`" = _ --'-Snp�cTank: Distance from nearest well - -''Di�ance from foundation 6- - Material---- No. a+oria' ' No. 6f compartments----��= U - --------------- Cesspool: � material &�~ Distance from nearest w�U-__-_..�idnnoy from {uun6u+�n��.��_Uning mute�oL----.—.__-_� [] Size- Diameter_''--_.'''''''�--Dopfh---------------------------------------------------- ` Privy: Distance from nearest well---------- --------------------------------------Distance from nearest 6uildlng�-^.-.''_---'---- El Distance to nearest |o+ line------------------------------------------------ Seepage --------'_--__-._.Seo a Pit: Distance to nearest well-------- from - - -_Distance fo nearest lot line. Num6erof � ��| �� �-^ '�� «~��-� ----'--- --- ------ ~~ --r'' ------------ JJisposa| Field; Distance from ,�`�. � ine && �]yNumber of kr Long�� ofa�c� Une ---Distance to nearest lot in -��.��..~-'�--.VVi�+h �� nc ' Type offilter material- Depth of filter moteriuL------ -. ` Remn6ving and/or repairing (cle�°'ib" ��'- _-�---____________-'`-_'_____________ _______________. ------____ � '_____.__..___.--___.--_.__.--__-.______---_--_--_-------__—._..---__---_________--_---. �. _---_'--'-__-_'-_-''_-.'_-'--__.-_-_----��-�-- -'''-_-''''-_.-'-_'''-'''-''--_'__--'--_-.--''--. .--'-_'-___-''-'''-''--'-'''____---_�._-_--._---_----_-----------�----__--_---__.�-�__' I hereby certify that I have prepared this application and that the work will be done in accordance.wifh San Joaquin County ordinances, State laws and rules and regulations of the San Joaquin Local Health District. ' (Signed) -~- --''''_-.'_ Contractor) ' - -��_.��--�_-�� --._'''-�_-��---.—_-..`--,~_.___--~- -------------------------------------- (Plot plans, s owing seize of lot, location of system in elation to we|ls, buildings, o+c., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED 8Y-------.. .A]----------_-----. DATE- REVIEWED ATE REV|EWED DY____..__-_—._-_--.�~�~« --V?-------------------------------------------------- DATE -- ` -- BUILDING. PERMIT ISSUED---------------------------------------------------------------�''-��'�'__'''--------- DATE �------------------------------ -'''--'.___- Alterations and/or rmcommmo6afious:---------- -------------------------- - ...... - ---------------------------- -_-__________.-�./_'_ _-_-_-_. �_.- . -_.-_'_--__'--_'-_'''__.-''__.'----'-''-_- '-__'-'___----_---.-_----___---.__�_----_.--- -. �-�--''-'-_.___-'-''--'-''-__-''__.'-'-_.'''--.'''-__-�'--__-'''-__.'--__''_-.''---''_--_'-- �-' -_-_-_--_---'_--'_----_-._-�-- ---_---._-----_---.-_---__--.__--_----------__--- � '--'-''--''--'','-''''-'''---'''--�-''��--''''-_-'-_` '''''---''----- - _�'_-'''-' _-'---'---'''_' ------ PERMIT - |SSUE[\'-�F�1�-4.��'�^_(Dnt� FINAL INSPECTION BY.'L -1')- __—.__`____ Dnte----------------------- -1, ------- SAN .''` SANJCAQU|N LOCAL HEALTH DISTRICT 130 South�American Street Stockton, California