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FOR OFFICE USE, -- -------- - ` <br /> APPLICATION FOR SANITATION PER@�UY � <br /> ����----'' <br /> �ommp�YmMw pmrn�f�� '.—_�~.__. , <br /> -- . <br /> This Permit Expires I Year From Date Issued <br /> Date Issued <br /> - <br /> ^ � ' / <br /> herebyvpN�m �un �� N � ' <br /> Application Is � <br /> described. This application Is made In compliance with C6unty Ordinance No. .549 and existing Rules and Regulations, <br /> and Install the work herein <br /> Address -7 --'---------'-Phone~ <br /> ---.x,c".�-.� -_--'_-- C�v ---.��'/]y.x�� ����?���_ <br /> ' - .......... <br /> con+*zctoruName ------- x0: �/n0..f--------------- ------------------------------------------ lhcenne # .--.----- Phone --_-_''''_ <br /> 11 <br /> ���� �|l �� Residence HouseMCommercial C]Tra|ler Court 0 <br /> 1Motel []Other --_'-- ! <br /> -----------' � » [ <br /> CapacityNumber of living units------------- Number of be �ooms ...�'--Garbcl e Grinder Lot size .......... <br /> Water Supply-. Public System and ri� ........ <br /> Character of soil to a depth of 3 feet I.: SandEl Silto Clay' C] Peat 0 8andy Loom Q/Cloy Loam 0 <br /> (Plot plan, show' <br /> Ing size of lot, location of system In relation to wells, buildings, etc, must be placed on reverse -side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permitted If public sewer 's liable within 200 feetj <br /> PACKAGE TREATMENT SEPTIC TANK[ Size.11 lall. <br /> ' ^' ------- --`~~^' ~~^ ~~)~^ No. C,.9^p,vnnn, <br /> Distance to <br /> + yl Foundation ''---'''-' ' '~'' ~~^~ -~~-�'''---. <br /> LEACHING LINE. <br /> No. of Lines -'-x�---------- Length <br /> � ---' Total _- <br /> Ra ine <br /> '�� �o� -..^/ Type R�ar Filter~ - ' � ----�'/,r-'----��^r^ �»°^=^= --'o0�, ................. _ \ <br /> Distance to nearest: Well .. / ^�.//-.-. Puun6mdmn -. /'a------' Property LineSEEPAGE PIT <br />� [ }� Depth .................... Diameter .--------------- Number ---------�Rpck |9Ue6 Yew [] No C1 \ <br /> VVoh� T�6J ' Depth�a��� . <br /> ` . e ------_----'__----]��w���w _ .......................... � <br /> \ � <br /> ` O8�pnc� �� nwu,esf VVaH 'JFoun�wtk»n <br /> . ^ ' _____.__.______... -.--_.--... Prop. 0nm --'_--'---' <br /> ����V (Prev. �pnh�d�nP�rmlt# ............ .-. ----------------- --- Date .... ................ ........... <br /> j <br /> Septic Tank JSpecify Requirements)' -------------- -.. ----------- <br /> --_- --_--_-- <br /> � �� r '�~---�—'---'-----'' �~ <br /> Disposal <br /> Z�i <br /> Field Meqw -- -.---~�(�.--' «'. ----_----.--...'-. <br /> .---.---_---___---'- -_._--_.___._-'--'�_-.^-'-_--'-_ <br /> - 1 --'--'— . .. . ... - - - - -- � <br /> _- ----.-- - - - .--_-'—^'.---.----_-.—_--__—...'_.-._-_-_-- - - - - - - - . <br /> owiutngmn6 ,equre6o66thnnonvmvmrommdel '----�-- ' <br /> Uhereby certify that I have prepared this application and that the work will be done In mmmondanmw with Son Joaquin <br /> ^ <br /> County Ordinances,-State Laws, Sow Joaquin Local ,N � <br /> m� h District. Home owner or licen- <br /> sed agents signature certifies°merw". ` <br /> ^ certify that in the performance of'the work for which this permit is issued, 8 shall not employ any person in such manner <br /> cis wxbecome laws of California." ' <br /> �i�ne6 ---.-_----- O^wner ' <br /> By ---------------------------------------------------------------------------- . <br /> �fother than owner) '---' ~'- ------------------'----'- ' <br /> � ' ^ . <br /> . <br /> VR DEPARTMENT IfSE ONLY <br /> | <br /> ",,^Cm'"Om ACCEPTED w� DATE ...... <br /> DU|1CxN� PERMIT |S8U28 -- ' ~�' ----------c~~^'~�`--'�--' <br /> �DC8TkJNAi �O�UNENTS -------'`r-------'------------------,DA7E -------_-___�_� I <br /> ---------------- <br /> --!�-------------------------^ ----- <br /> --------------------- <br /> . <br /> ------'-----_.L .___ _^__ _ +__. _ _-._-_-__'_ <br /> ----------------------------- - - - <br /> ----'- ---. <br /> ------------ ----- <br /> ~~'~ ��mz/ |nspacUmm6-,.. <br /> E8 13 2b 1~68 '--',' <br /> �m SAN ]OAQbUN 1O[AL HEALTH DISTRICT M�r� <br /> ~/ '� 3M <br /> � <br /> ` , , <br />