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APPLICATION FOR PERMIT <br /> + SAN JOAQUIN LOCAL HEALTH DISTRICT <br />' 1601 E. HAZEL T ON AVE„ STOCKTON, CA �j J <br /> Telephone (209) 466-6781 ! <br /> rr <br /> 1. PERMIT EXPIRES 1-YEAR FROM DATE ISSUED <br /> (Complete in Triplicate) <br /> Application is hereby made to the San:'Joaquin Local Health District for a permit to construct and/or install the work herein described. This application is <br /> + made in compliance with San Joaquin County Ordinance No.549 r No <br /> for sewage o . 1862 for well/pump and the Rules and Regulations of the San Joaquin <br /> Local Health District. z--5' ft f3a k p f /3/G/5 /' Z�✓�r S� �o /��/ <br /> l3i � <br /> r Job Address _ ZO le1 i� �� <br />