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' <br /> APPLICATION FOR SANITATO'N PERMIT Permit No. <br /> � (Comp�� � Umn�af� o� � <br /> ' ' ' Date 1oun6 � <br /> J o| �ere6v mu6e � the Son Jooqu�n ' u| Hoo|H` Diofr�cffor r p°nnif |u cnn`�uct and install the wn� ' � <br />� |hbapplicatiois n in compliance with County Ordinance No. 549. , <br /> _jD LOCATION--- <br />. - <br /> ill <br />. Installation __ serve:_ __~.~~.,, A] Apartment, House Commercial E] Trailer Court El Motel LJ Other El <br /> Number of living units'.` A_. Number of bedrooms -at--- Number of baths A---- Lot size <br /> Wafer <br /> Wafer Table <br /> � � _ _ � to. <br /> Character of soil to a depth of 3 feet: Sand Gravel F] Sandy Loam Clay Loam [] Clay El Adobe El Hardpan <br /> Previous Application Made: Yes E] No UV New Construction: Yes Z No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS. <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest 11 fh--#---Distance from founclafion-14--/t---M ferial----&_12o�_ <br /> Capacity- <br /> Disposal Field- Distance from nearest weN__rx0____-D!stance from fou Dist,nce to nearest lot line------ ----- <br /> Number of lines---I--- Length of each line----f1d A- PI-----------Width of frenc <br /> Type of filter mate ria Depth of filfer material-----7#---------Total length---- -- --- - <br /> Cesspool. Distance from nearest well-----------------Distance from founclaflon--------------------Lining material -------------- <br /> ----------------------- <br />~-- ~~=�~-D -~- | '- - ~- <br /> ance <br /> etrFf <br /> D�+on�o +o nearest �� |in�`'-�---'''--''__.''-_--'---'''-__.'''' - <br /> [� <br /> Remodeling and/or repairing (describe):---''-_-'--_.'''-''-_--'_----_-__'---__---_-___-__..__.________-_� <br /> ------------------------ _-------.-------------------------------------------------- -------------------------------------------------------------------------------------------------------------- � <br /> � <br /> ---__--_-_--'_______._..____------___.---'-'-_.____._..___. ------------------------------------------------------------------------ <br /> ----------------------------------------------------------------------------------------'-_''___.__.--�___'''-__---___-'__---_. <br /> he, '-----'--- <br /> . ~~ in accordance with San Joaquin County <br /> ordinances, Stateof the ~~^ ~~~q" District. <br /> ". �°"". .v*nn <br /> '----'^---'--'------'--'--------'' am <br /> 8v� ^ <br /> ' --'-------------'--'-------'-------�,---__---.-'�T��)__._.______�___ � -_ <br /> /P�fu�n. ,hw*�g s�� nf ����caf�nofsystem hm ,e�f�ntuw��. buildings, mfc, can'be .' co6omroremo �de� ''-'''---' � <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED � -��--������--- D,�TE-_~-^�~-'���'�� <br /> REY|EVVED8Y�------_--�^~�-------.-------------------'------ OATE_--.--__-' --'`-------- <br /> DU|LD|NGPERk4|T |SSUED...--.---_---------.----.--------__------' DATEAlterations and/or=n6/wr ,ecmmmon6aHomu--__----_-----'-__-._'_-____-.--__-._ <br /> ---_'-''_--__.'-----'''--'-__.'-'-'''_--'-'-�.----'''---�'---'''''___-''__.'''-____.-.__.._____ ' <br /> -_._-------_--_---__--_-._--__-.__-.---..__---__._-_'-_.____.____._.-___--__. � <br /> ---_.'--_--''---''-'-''----''--''`-'''_-''''----'__-''''---�'''-'''''-_-''__.'''-'''-'-'--'-''-_--__ . <br /> -_._._-'__----.. -.--_.__—_- <br /> FINAL INSPECTION 8Y D« ---- <br /> 7_7 ' ` <br /> ------- ------------------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRI <br /> --_-.-SANJOAQUUNLOCALH2ALTHCIDTRkCT <br /> /xv y".m Am°w"°" $tr°"+ 300 Wem Oak Street oz yv"°m"re Street ow w=+h ^c^ Street | <br /> Stockton, California Lodi. California w°"fvm. California Tw"» California <br /> ES-9-2M 8-5/ Revised w/-2/00 . \ <br />