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FOR OFFICE USE: �s3� 11-�5: ZPermit No. �� RNITATION PERMIT --------------- //- -------- (Completein Duplicate Date Issued -- ---/- _j,'/7 This Permit Expires 1 Year From Date Issue d. Application is hereby made to the San Joaquin Local Health District for a permit to construct and instal4 the work herein descri e This application is made in compliance with County Ordinance No. 549. --------------E JOB ADDRESS AND LOCA/TION----- ----." ®- -- Owner's Nary+e._ ----fes-, ovmg .o�slov--- ---- ----------------------------------- - ......... Phone------------------------------------ t �a •-----------------••---- Address----..._�1��---r-'--� -;----------••---•--- ---------� -------------•----- ------------------------------------------- Phone----------------------------------- Contractor's Name------ "� � ------------ 10 t.� ion will serve: Residence Apartment House 171 Commercial F-1TrailerCourt Motel El Other Installat Number of living units: _,--- 1`lumber of bedrooms _A-- Number of baths.J '----------------------- _._._ Lot size ." �' ,P-ft Water Supply: Public system El Co mmunity system El Private Depth to Water Table Adobe gj--H*ardpan ❑ Character of soil to a depth of 3 feet• Sand ❑ Gra-vel ❑Sandy Loam ❑ Clay Loam ❑ Clay ❑ lvJ i U. No ®�FHA/VA: Yes ❑ No P - Previous Application Made: (If yes,date__---- ----------�) No [�� New Construction: Yes ❑ -�. TYPE OF INSTALLATION AND SPECIFICATIONS: r,21 (No septic tank or cesspool permitted if public sewer is available within 200 feet.) k Se�tic Tank: F Distance from nearest well---------- from foundation__.________-------Material._..-..-______--.._____...---________..-___.... No. of compartments------------------ ----- Size-------------:------ --------- Liquid deP.t� - Capacity Disposal Fulda Distance from nearest well_. --Distance from 'foundation Distance to nearest lot ine___ en th of each line__._- - ------------Width of trench-r .-----.-.-------------------- kn Number of lines---------f---- g T otal len th__ Type of falter material.�� 0 epth of filter material____ 9 0 Ilk, ' • f -------- ____.Qistance to nearest lot Gn` .__Ar�.----- F Seepage Pit: Distance to nearest well__ ep-- ---Distance f�r fou dation__-__-_ __."" it Number of pits-.- _41---.. Lining material---Z Size: Diameter_ -_'-------Depfih- --------- Cess®o Distance from nearest well _______________Distance from foundation..__.----_.__-- ..Lining material__-----...__..-----------.-------- 4 Li uid Ca acit gals. ❑ Size: Diameter. i---- ------ -------- ----De Depth ------- ------ --- ------- ----- q p Y ' I p Distance from nearest building---------------------------------'-------- Priv Distance from nearest!well_-, ----------------------- ❑ Distance to nearest.lot lire ------------r--------------------------/------- e� - Remodeling and/or repairing (describe):"- n�yG®--e---------------_.-._.-------------•----- ------ ----------------- ----•--- - - - ------- s. y that I have prepared this application and that the work will be done in accordance with San Joaquin County I hereby certify [ ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. I ' ---- -.---- ----- -- (Signed) r Contract rt� � � Contractor] , � - 0 4 ...... - [Title) t� - --- li I By:------------------- ----------- ---------------------------- buildings, etc., can be placed on reverse side]. (Plot plan, showing size of lot, location of syste relation to we11s,� I FOR DEPARTMENT,USE.ONLY iED BY- DATE-- �'" 7------------------ ?e'APPLICATION ACCEPT - -ZZ-- K� Vie' �L..._ REVIEWED BY--------------------------------------------------------------------- --------------- ------ DATE-------------------------------- --------- .. t BUILDING PERMIT ISSUED-------- -- ----------------------------------------------------------- �- --------- DATE-------- -- ---- ---�- ------------------------- k -----------�---------- Alterations and/or recommendations:_.- "./----�--- --------2��1------ )-------- �. ° r ------------------ I -------- - 7 Date.-"---- - l�° 1�I ------------------- ---•--- FINAL INSPECTION BY—.----------��-- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Naxt►Iton Ave. 300 West Oak Street ?,t 124,Sycamore Street 205 West 9th Street „- Tracy,California Stockton,California 4 Lodi. California Manteca,Californic' E.H.9 2M 1.67 Vanguard Press