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` f S Permit No. r <br /> APPLICATION-FOR SANITATION PERMIT d, l <br /> 4 <br /> ;° [Complete in Duplicate) <br /> ;. Date issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> sa - <br /> JOB ADDRESS AND�LOCATION_' _ ---------•- <br /> Owner's Name-------K`-!� fO_tQ ...-.-_ ------------------------------------- Phone---------------------------•-------- <br /> / rb -Address__....----0---------• ----M1-- I <br /> Contractor's Name_..__ 1` fl �~ ------------------------------------------------ ---- Phone----------------------------------- <br /> Installation will serve: Residence �partment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: _1_____ Number of bedrooms :,.?_ Number of baths _�__�?'Lot size ...6.8--.---X-•-�-7-�--- <br />