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APPLICATION FOR SANITATION PERMIT PermitNu - � <br /> in Du+n |mme6 � <br /> o ` u —'-''-'-- <br /> A lication is hereby made to the pp <br /> Son Joaquin Local Hou|+h District for o permit to construct and in,faU the work herein described. <br /> This application ismade incompliance with County Ordinance No. 549. . <br /> J[ 8 ADDRESS AND LOCATION --'�« � ~� <br /> --------------------~- ---'~~---'- <br /> ---'------ <br /> (� or'� ��� ` �- ����-----------. Phone-���'����/ ^�--.. <br /> Addr% ess ����� --._...'___.________________________ <br /> Contractor's Nnmo_____-----_ Ls V _.Mit-C---------------------------------------------------- Phone------9-f _ <br /> will ' Residence <br /> ' House El Commercial L] Trailer Court [] Motel| E] Other E] <br /> Number of living units: j--- Number of bedrooms k�Num6e, of 6u+h, /_' Lot size -= AP----:6n . ~12--------------- ---- <br /> We <br /> - <br /> ----- <br /> Wmfar � <br /> ��oo�: Public �yv�m� [] Community system [] Pr��to Ga�'D�of to \�uto, Tu6|o --.. ft. <br /> Character of soil toadepth of3feet: Sand [] Gravel [] Sandy Loam [] Clay Loam Ej O Adobe Og Hardpan E] <br /> Prm`|mvo Application Made: Yes E] No �� N�* Construction. Yes [� No �� <br /> � -- -==--r ^ - <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: ~ � <br /> " (No septic tank or cesspool permitted if public ao*ar is available within 200 feet.) <br /> lip�onk, fance from nearest well-----------------� <br /> Distanco'from foundation ::-.Material <br /> Disposal Field: Distance from nearest well-. Distance from foundyf' n------b0_"_.Djsfance to nearest lot line------ <br /> Suepoge Pit: D; funcr to nourest well������ --._Distance from foundation------------- Ditmnce +o neont lot line F-1 <br /> Number p��'-'''-'--.�n�g mof�`�L��'''����Sbu� Diameter _'---'D�9th------''''- - <br /> : Distance from nearest well''''-''-Distance from foundation--------------------Lining matehaL-'''-''-''-'-- <br /> Size: Diameter--------------------------------------Dept h----------------..Uqu|d Capacity---------------------------gals. <br /> P ' Disfancu from nearest well-'''-''''_--''''-'''-''Oistuncu from nearest 6uU6ing- ------------------------- ------ - <br /> E] Distance to nearest |o+ line-- --------------- ------- --___-----.--------- <br /> ` o|ing and/or repairing (describe):------------------------ ------ -_�4,»�.-.. <br /> ' <br /> ---------------- <br /> ---------- <br /> --. <br /> .._--_'-'.-_'_-_---.-__--___..---'___.._--_-..___.--___-_-- _�,~ -_----' K~ <br /> -'-- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ -.--.--.----. <br /> that th k ill be done in accordance with San Joaquin County <br /> c re ycen . ti . e wp' W' <br /> J- - - - -----------------(Title)--- ..... <br /> (Plot plan, showing size of [of, location of system in r /flion to wells, buildi S, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY Y/z -------------------- U�TE' ~�,��� -/�� �� <br /> ---------------------�« ~~ �L� ----' - / '7--°-''�~--' <br /> REVIEWEDBY------------------------------------------------------------------------------------------------------------------------------ DATE-----`.-___----____. <br /> BU| NG PERMIT ISSUED----------------''''-'''----''-''' ----------------------------------------- DATE--------------------------- <br /> and/or ,eonmmend ations:----------------------------------------------------------------------------------------------------------- --------------------------------------------------- <br /> �-----__----------_------___-------___---_------- -------------------------------------------------------......................------------------- ------ ------------------------------------- ---------- <br /> � <br /> -'�-----------------------------------''-'''----------- ------------ ----------- ---- ''----''''-''''--.''''-_-'--'''__--''''' ---------------------------- <br /> -------------------' ---'--`-------------'--'-----------'--- <br /> ^__��__�_��� ������_�_�__ ___��_�__����'___��_ � '�_��___��_ �_ ��_�_��_�� <br /> � �v/ <br /> , � ^/~° <br /> FI NAL -INSPECTION 8Y�------.��-,�6� --' Date-----'_---------.--'--------------- / <br /> : <br /> � . <br /> SAN JOAQU|NLOCAL HEALTH DISTRICT <br /> k <br /> ^ mo s""m American Street 300 West Oak Street /32 Sycamore Street xw w"*h "C" Street <br /> " <br /> Stockton, California Loj/. ca|/6"=/° Manteca, California Tracy, California <br /> ° . <br /> ES-9-2M /0-52 navaoa vv-2/00 . <br />