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FOR --'- ------------- APPLICATION FOR SANITATION PERMIT Permit No. (Complete in D°r"~a'=) Date Issued ' --- This Permit Expires 1 Year From Date Issued — Application is hereby made to the San Joaquin - Health Dist rict for mpermit toconstruct and install the work herein described. � This application is mm6m in compliance with County Ordinance No. 549 . JOB ADDRESS AND L<]CAT|��N-' -- ^��.--��x7 _^______..____.________...-_.--'_-_.---. Owner's _'___--_____-'-_.''__-'-'__ 'x^S- Address ��---------.��/---'*��/ _-��..�u�-'�� ------------------------'---.......---------------------................................................ ^ � Contractor's Nomm-.-ni8�'.^5?.'-' . --I-V /W. phooe �-42 7' ! |nstmUofon will serve: Residence oj� Apartment House [] Commercial [] Trailer Court [] Motel Fl Other [] Number of living units: '_/.- Number ofbedrooms ---/-- Number of baths /.-' Lot size ..-7,f~.,----_---'- Wter Supply. Public system p� Community system [] P6vuh* [] Depth TO VVuto, Table _6 P__ Character of wwO to m depth of 3 feet: Sand [] Gravel [] Sandy Loam [] Clay Loam W Clay C] Adobe NJ Hardpan �7 Previous Application Made: (if Yes,date----- -----.) No [m New Construction: Ye, [] No W FHA/VA. Yes [] Nu'X� TYPE OPINSTALLATION AND SPECIFICATIONS: (No *opfic tank orcesspool permitted if public sewer isavailable within 200 feet.) 6o '- Tank: Distance from nearest Distance from foundation--/O/--_W�+�riuL- --.-.- � � No. ofcomportmenfv�::-.-Z----------------Size -��.'Uquid 6opf6--------"Z �........Capacity--- Disposal Field: Distance from "eu,ost L Uistanxe from foundation...AP./........Distance to nearest lot |ima s- /._ ` Number of lines........... ----'-.-LmngH` of each line-----------Zs_------------Width oftrench--------- -------- Type of filter '- Typooffihero+ offilter mute,mL.��__To�|'�mofh--__---��L._---. � Seepage Pit: Distance to nearestwe|_--__..Distance from foundation....................Distance to nearest lot-line----------- .- [] Number ofpits----------------------Lining material_--_--------Size: Diameter....-------------------Depth................................. ! � Distance fmn` noora, wmL''---D�+mncofnom foum6u6on'' ��'�_-Un�g motor�L''''--_.'---''' ' ' / [] Size: Diameter--------------------------------------Depth . .Uo |6 Capacity ry . . '�al s. � Privy: Distanco'fnom`nouireotwell _-- ----------------------------------Distance from nearest bu\|6|ng!._._-_--..---.- �T �] Distance tonearest lot .|ine-_-.---.--_- ------------------------~ '__-_ .-_--------------------------------------- Remodeling -_�---�------. Remn6�ing and/or repairing (describe): 4?11(��..-~791'xV ^---' ' K � __--___-_-- -_.'_-� ''_-._--__.---_------_-_-__-_-_-.-�-��-_- --''-_.-------.. . .. '--'-'-------'--------'-----------'-----------''----''----'---'''-'---'----''---'--''-' ---------------------------------------------------------- -------------------------------------------------------------------------------------------- ----------------------------------------------------------------------- | ' certify that | have prepared �f� application at|pn and that the work °ibe done in accordance wRhSan Joaquin County � or61nmncos, State laws, and rules and regulations of the San Joaquin Local Health Dl��t ' �J(Siyne6)...-_u -' -------------------------------------------------- wner and/or Contractor) ' Bv:..-.. - '-_-----_._-----.-_---.-..�T�wl--- ------- /P1n+ plan. showing size of lot, lofftion of system in relation +mwells, bwUdimSa, mfc., can be placed on reverse side). �qlk DEPARTMENT USE ONLY| / REv|EVVED BY._.-----.------------------ _-..... -------------------------------------------------------------------------- DATE-------------------------'---------- --'-- --- BUILDINGPERMIT ISSUED----------------------------------- ..........---------------------------------- '---------------- u,+ E--''-'__.-_-_''--'-'-''-'-- Aherm+ionwmnd/w, ------------------''_--'-------''------------'�-------------' . . '-............ --------------------------- --------------------------------------------------------------------------------'---''--'--------------------------------------------..................... ! -'-'--'--'''''_''-'-''-''-'''-'--'''-'--'''-'''''---_-''---'-----''--_--'''--_''-----.''-- --'_-'"�.--''_.--- � �� ----''--'''--''''-''''--'-'-'-_-_--� ''''-'--._-''-'- /| --'�-'-_-'''-----' -''---'''''-'-''''-''''' ''-'-- x.-_-'Dute----.--.FINAL INSPECTION 8Y� ---- �� r� � t�� ' SAN - . ��U|N L�*��L HEALTH O�T��[ ' 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street �. .� ' Stockton,California Lodi,California m=teca,California TTocy,*alnornia ES REVISED 8-55) F-w5'vzATLAS