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� <br /> FOR OFFICE USE- <br /> TION FOR SANITATION PERMIT Permit No. <br /> ----. � <br /> ` <br /> , <br /> This Permit Expires 1 Year From Date Issued <br /> applicationApplication is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> ade in complianipe with County Ordinance No. 549. E�C A LO Iq <br /> 6 3(91 . <br /> JOB ADDRESS AND LOC TI ---- <br /> Add It- ' <br /> mercial E] Trailer Court [311' Motel [] Other 0 <br /> Installation will serve. Residence 23"'-Apartment House Com <br /> \A/ater Supply: Public system [] Community system LJ rmvuna U� uvpr" .o Water ."="-~~.- '.. <br /> Character of soil. to a depth of 3 feet: Sand 'Gravel C] �alncly Loam F pan <br /> Clay Loam 010ay ',Adobe El Hard <br /> Previous Application Made: (if yes,date-------- N o J��' New Construction: Yes 0 No 0"FHA/VA: Yes E] N o F!�r' <br /> FIFFIVIOP- <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> - - -UNSe _� '' honx(m .op*n| permitted /,.pu�x� �piem, is available wit ~.~ <br /> Distance from nearest well--- Distance from foundation...1-0 M | CONC � � <br /> Disposal Field: Di-fance from ne4 <br />� u�wch lin <br /> mumnaro, /mv� , '-''-^~'�.. ~ ..- - ---------' <br /> ADM <br /> Number n+ mc ,�' u mu,�rm�_^=^=^� ^.'� ~~.�.~°` <br /> Cesspool: Distance from nearest well-----------------Distance from foundation-------------------- -- <br /> Distance from nearest well---------------- <br />� Privy: Oi��ncefona*nu,+ |o+ line -----� .. .�.--_--_-_-___.-_�. ___-______---___ <br /> LJ ----'------�--'' '� <br /> Remodeling and/or repairing (6os r;bo):-''- ---------- --------------------------------------------------------------- _-'''''--------------------- -'''-----'-__- <br /> ` ___.�___--''-------------'-'----------'---'r--'-------- <br />. '----_.'__'_-.-' ---_ ^ -_---_--__---__-_------- y..__-_-.--'��-._--_-------' <br /> -'''----''� ''-'-' -._--_.�__------___.--�'--''''----'-'-_ � '--'-'''--'__'-''' <br /> I hereby certify th-at'll Wa_v'e*_�r_epar7d'fhis application andithat the work will be done in accordance with San Joaquin"eoL;nf y <br /> --------------------------------^'----..-- and/or Contractor) <br /> � �=* -�~�,~ <br /> I <br /> ' (Plot plan, showing m�o �� lot, location of system in relation to'wells, buildings, ^^.^ can be ,-_'l on�- reverse , <br /> FOR, DEPARTMENT USE ONLY <br /> ! = ' "`^`''~'` ' ^-~E '-~ -''-- DATE 8Y''-''''-''-'_-'-'-__-''_'-__�-_'_�_-________-_______ ______________.______ <br /> D/�� <br /> 8U|LD|N(� PERMIT ISSUED--.-_-.-'___-_-----.__--------_-. .-------__-.---------------- <br /> Alterations and/or recommendations:- '--'--���------''''''_ ----.-_----___-.___-------_- <br /> '--''---''_--'''--''_'''' --'_'''_-''--'''''---_-�'�� --« �---'''-'-_-''-'^'''''_-----_---- <br /> -------------------------- -----------------------------------------------------------------------------------------------------'������������.�����----'---------.------------------ <br /> ___________��__'______________-________ <br /> ��_�� <br /> -'--'-''---'--''--''''-----'------ <br /> ---'----- <br /> ��~ <br /> �� �� _ ��_ <br /> �Y \ Ou+o ^�� �^� '���� ^ ------- <br /> RN/\L IN3LLa .^^-~-. -'�'-''_� _'_ '_ '' ' <br /> DANJOAQU|NLOCAL HEALTH.DISTRICT <br /> 1601 E,w"ze»""Ave. 30ow05tu"k Street oos.w"*w*Street <br /> u,a/ c"x�,"/" Manteca,California Tracy,California <br /> u��m" ��n"�� , <br /> ~ � <br /> ,." ��"�� _-�_~� <br />