Laserfiche WebLink
FOR OFFICE USE: APPLICATION FOR SAM TATION PERMIT Pe(mit <br />. N This Permit Expires 1 Year from Date Issued <br />made to the San Joaquin Local Health District for a permit to 10011stfuct and install 1he work herein <br />Application is hefebf, Originance No. 549 and existing Rules and Regulotions- <br />described. This application is made in compliance with County <br />Plum <br />-.4- artial aTraller Court <br />Number of living units: ...... Number of bedrooml�� ...... Garbage Gri <br />Water Supply. Public System anti name ... <br />Character of soil to a depth of 3 feet: Sand Slit 0' Cloy t <br />(plot pion, sh&wing size of lot, location of� system in relaticin to�wells, buildings, etc. must be placed an revette side.) <br />NEW INSTALLATION- jNo septic tank or &eepage pit permitted If public sewer is available within 200 feet,) <br />Copaciv.* ............... Typelplu'-.06.101motericic kc <br />no <br />EACH(NG LINE <br />ne-G.-restl Well Fo ation . ........ Prope" Line <br />Yet tr-140 <br />(Draw existing and requ a ' dditi n on- reverts 4 ordoma with SGA 40040in <br />this applkafi*n and that itho worit will be. do* Is 04C <br />I hom6y certify that I have prepared San jouquin Lbed "Oulth Distirld. Nome *wVW or ficen- <br />County, Ordinancos, state Laws, 4nd Nut" cod Regulations of the <br />sod ageots signowris cwfifi" the followingi whIA this V"t Is 1"u", I OW. not employ any person In such manner <br />"I certify that In the perfemaAft Of fh* work for <br />as to bscom* subject to Workman's Compensation lawt of California." <br />(if Oth,4nn owner) )A DEPARTMENT USE ONLY <br />