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~ Z-, <br /> / <br /> � . <br /> APPLICATION FOR SANITATION.PERMIT <br /> KCumm|afo in <br /> Application <br /> is hereby made to the San <br /> 'Joaquin Local Health Dlis�rictfor mpermit to construct and install the work herein described. <br /> ' <br /> This application '^ ^~d~ in ^~^'r~~'`~ with ~~~^'/ ~'~^~^`` No. 549' - <br /> JOB ADDRESS AND LOCATION �� T ' -- �- ���� � « ' � -------------------------------- <br /> A <br /> /J � , ` |)` <br /> __________------'_-_ Phone----- <br /> Installation-will serve: Residence E] Apartment House E] Commercial y Trailer Court F] Motel F1 Other El <br /> Number of living units: M Number of bedrooms El Number of baths Ey Lot size------------ ��' ~-^'------------- <br /> Cesspool:Water Supply: Public system El Community system M Private M r-%%, N1 <br /> Character of soil to a depth of 3 feet. Sand E] Gravel [] Sandy Loam Clay Loam 0 Clay E] Adobe Ej Hardpan 0 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS- <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> � Distance '_m _nearest well-----------------Distance_ '_� ' � ' <br /> S�ze: Diameter-------------------------------------- -__-_-_-.___---_��' / <br /> Privy Dlsf nca from nearest well Distance from nearest building <br /> '------------------------------------------ <br /> El <br /> ' <br /> Seeere Pit: Distance to nearest well--------- ----Distance from foundation---- -------Distqnc�q to nearest lot <br /> Disposal Field: Distance from nearest we]-----------------Distance from foundation--------------------Distance to nearest lot line----------------- <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joa4uin County <br /> ordinances, State Iaws_and_rules and' regulations of the San Joaquin Local Health District. <br /> (Signed)-----------__,z------------------W--- ----11 .... .... - --------------------------------------- (Owner <br /> ' �7i �.r---0---- <br />' <br /> FOR DEPARTMENT USE _ LY <br /> '- - -- ------------------------------ 'wo ^ <br /> ' �� <br /> BU|LD|N�� PERMIT ISSUED_-'-�__.�=�-'_-.'''_'''_------��'�����--_''-- DATE_-''_�-'__.---''-''---_--'' ' <br /> AKo,aGonomn6/or ,ecommon6aMwnx:---_--_------------_--.-_--.----.____--_.-________.________-__._______.. <br /> ._-____'..__..__..____'_______-..__-__---..------___-.__-_--___-___-.-__-__--_-__--_---_. -� <br /> -_-___--.__.__.__-----_--_--__--._-_-._-_-__-_-___-..-__--.--_.--__.._----_'_-_._ ' <br /> � <br /> __�_____________'_�_-_���__�_______________________���---_____'______'________________'__________ <br /> ---------------'--------------------'---------------'�������-----------------------------------'-------------'���--------------------------' ��'' <br /> ---------------------------------------- <br /> PERMIT No <br /> -------------`----'PERk |TNo .+_»".4_--' ISSUED _ . �(~~.~/ FINAL INSPECTION BY.4 ~ ~ ---.------- <br /> Da+e- /4! --------------------------------------------------- <br /> SAN <br /> ---.__-._._-_-._SAN <br /> 1 <br /> JOAQ0N LOCAL HEALTH DISTRICT � <br /> � <br /> � |30South American Street <br /> Stockton, California <br /> ES-9-2m9-50W-/639 � <br />