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~ <br /> � <br /> I APPLICATION FOR SANITATION PERMIT <br /> � <br /> (Complete in Duplicate) � k <br /> (""�Application is hereby made to the San Joaquin Lcca� H Ith Di frid for a permit to co truct and install the work herein described. <br /> a fi f* ' d in compliance with Col 8r Knance "'No. 549. <br /> 03 N?l <br /> Installation will serve: R ence E] Apartment ouse [:] Commercial Al Trailer Court [] Motel 0 Other E] <br /> Number of living units: E] Number of bedrooms E] Number of baths 0 <br /> Water Supply: Public systel Community system P Private F1 <br /> Character of soil to a depth of 3 feet: Sand 0 Gravel Sandy Loa M Clay Loam E] Clay E] Adobe E] Hardpan Ej <br /> ifted if public sewer is available within 200 feet.) <br /> (No septic tank or cesspool permi <br /> Septic T nk: Distance from nearest well------—-------Distance from foundation-----------.----Material------------------------------------------------- <br /> e e l 1 4 <br /> (-)Disposal Field: Distance from nearest well---- Distance from foundation-----Y_�------Distance to nearest lot'line----&------ <br /> Type of filter maferial <br /> -----Depth filter material----- <br /> ___­-----------------------------------------------------------------------------N I <br /> I herl certify that I have prepared this application and that the work will 6e done in accordance with San Joaquin Countyt <br /> ordinances, State I s. ind rul nd;rregulations of the San Joaquin Local Health District. <br /> Asignell-----------------ov <br /> location of system in relation to wells, 6 u i Id i ing s. l must 6e filed with this application). <br /> (Plot plans, showing I of Ill <br /> FOR DEPARTMENT USE ONLY ' <br /> APPLICATION ACCEPTED BY---------------1<�j!!0-_ - .%, - - DATE..........�J_ <br /> ' <br /> BUILDING PERMIT ISSUED-------------------------------------------------.----------------------------------------------------- DATE----------__----_._____. <br /> Alterations and/or recommendations:------------------------------------------^------------------------------------------------------------------------------ <br /> --/.---_.--_---_.- <br /> | ------'--------'----''— ---------------------------------------------------------------------------''�------------------------—---------------------------- ----------------------- <br /> ---------------------......---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> ---''--'--'--''--'--'---------------'----''-------'-----'---------'--------'—'-------- <br /> ---------'------'------_���------'����__-----------_------�___��_���_������ ���� <br /> / <br /> y � PERMIT No—(�7��1�f--- ISSUED--.-'`.----_.-----'(Dofa) FINAL INSPECTION --.. . <br /> ^, - '-------------------------------- - --- <br /> � <br /> Date--._-`�l��.'�`����6.�/'--'------'---'' <br /> � � <br /> � <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> 130 South American Street ' <br /> Stockton. California <br /> U-9-2M 9'50 W-/639 <br />