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OR OFFICE SE t'`, <br />a.,. .: <br />Permit No. _.. <br />L`l3 FOR' SANITATION'PERMIT <br />L}30-------------- <br />APPLICATION <br />Complete in Duplicate)Date Issued <br />Y <br />This Permit Ex ires l Year From Date Issued l_dw-0 <br />Joaquinp <br />rein described. <br />Applicafiion-is hereby made to the <br />aSan <br />ce with <br />Loco[ He <br />atnce' <br />NoCt <br />49_ <br />for a permit to construct and instal!the work he <br />This application-is made in_.compll"a 1 <br />e F_ _OB ADDRESS A LOCATI Phone_. <br />Owner's Name_{_ - - <br />Address----- r Phone----------------------------------- <br />Contractor's Name--------------------------•- Motel Other <br />Commercial Trd-+ler.Court <br />i <br />Installation will serve: Residence Apartment.Ho use <br />Number of baths.__ Lot`size __ <br />Number of living units:._/---..Number of bedrooms --N <br />to Depth Jo-Water Tablet ft. <br />r <br />Water Supply: Public system. Community system A 4 <br />t: Sand Gravel Sandy Loam Ciay Loam Clay AdobexJ Hardpan <br />Character of soil to a depth of 3 fee VA: Yes ElNo Elk <br />Previous Application Made: (if yes,date-______________ __ 1 No New Construction: Yes No FHA <br />TYPE OF INSTALLATION AND SPECIFICATIONS:No septic tank or cesspool permitted if public'sewer is available within 200 feet.) <br />anI Distance fro arfime is <br />well <br />SDiBance <br />from foundatiLquid depth _ <br />Material_------- <br />Capacity___________ __-- <br />f No. of comp ce to nearest lot line____ --- <br />Distance from foundation__ Ll_------Distan <br />isposaField: Distance from nearest well - <br />Length of each line____ Width of trench.__. -------------1--- <br />Number of lines_______.____ ------ <br />De--Depth of filter.material___.___ _ <br />Total length-------------------- t <br />Type.of filter ma}er al__`__ _ _ - P <br />Dista m f undation----k,0 •--.Di-stt`nce to nearest lot line----------------- <br />Seepage Pit:Distance to nearest well_ — - E, i <br />Number of pits----- -------------Lining material-- - Size.; Diameter_--- --- -Depth <br />1-------- <br />n <br />r i1. <br />d <br />ning materi <br />Distance.from:nearest well--------------_Di to ce f m foundation-- `_ <br />L liquid Capacity___----------------Cesspool: <br />Size: Diameter p <br />s 3 t <br />r Distance.from nearest.building__ <br />Pnv Distance fromnearest well-.-. <br />r <br />y:Distance to nearest lot line____.____'______--------- ----- <br />E <br />odeling and/or repairing (de cribe)---------------------Remt . <br />M <br />a <br />f <br />1 <br />x. <br />i 1 hereb cerci y that I have preparedulais <br />application <br />the San JoaquinhLocalkHealltheD.i}dc} <br />n accordance with San Joaquin County r <br />ordinancesf S ate Ls, and r es an g i <br />P - Owner and/or Contractor <br />G Lei <br />Si ned <br />i <br />T <br />By=------------ <br />Plot plan, showing size of lot, Iota ion of system in relation to ells,'buildings, etc.,-can be laced on reverse side). <br />FOR DEPARTMENT USE ONLY <br />DATE------------------ -`------------- <br />APPLICATION <br />74 <br />i APPLICATION ACCEPTI D BY_------•----------- R <br />j DATE----------------------- - - r <br />REVIEWED BY DATE <br />BUILDING PERMIT ISSUED------=-------------------------------'------- -: - <br />Alteration and/or recommendations: <br />f <br />9 c'-" ` <br />6 — Y- -- <br />e <br />if <br />w+w..rSSR4s..•i.a+...+r - .'.`-'. _ <br />a.a...ti <br />i'} r Date--- --d-`r --- <br />FINAL INSPECTION BY: <br />y------ ---- -- <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 E.Haselion Avo.30o West Oak Street <br />124 Sycamore street 205 West 9th Street <br />i <br />r <br />Manteca,California Tracy,California <br />Stockton,California <br />Lodi,California <br />ES 9 REVISED B-59 3M 3^'63 F.P.CD.