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, »r <br /> ' APPLICATION FOR SAN[TAT]ON PERMIT <br /> (Complete in Duplicate) <br /> Application <br /> is hereby made to the San Joaquin Local HeaJfh Districf for a permit foconstruct and install the work herein �e��6e6 <br /> /msopm � � <br /> /o, om made in compliance with County Ordinance No. 549 ^ ` ' <br /> Water --------------- <br /> Installation will serve: Residence 0 Apartment House E] Commercial Ej Tra'ler Court 1:1 Mofe: El Other El <br /> Number of living units: -[[] Number of bedrooms 21 Number of baths Lot size____-7_.!;7_.Xj_1 0 <br /> Supply. Public ^r'e ^ E] C" '"'="r `p=m E] r,pany 64 ' <br /> ` Character of soil to a depth of3.feet: Sand Gravel Ej Sandy Loam D4 Clay Loam El Clay Adobe El Hardpan El ( <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: ` <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> -~ <br /> Septic Tank: Distance from nnura,+ we4AQP _Distance from foundation-/ -'-_MuferimL '^& <br /> No. ofcompur+nonf,--2--------- <br /> ----------Capacity-----------------------Siz'n'!yWlX3X'�T---------Liquid <br /> '6~p|h-.- ------------ <br /> Cesspool: <br /> --Caopoo|: Distance from nearest well-----------------Distance 6nm foundation--------------------Lining material ._--'---�.- w' <br /> LJ Size: Dia meter_----__---___Deof -_---------_------.-- '' ---- - <br /> Privy: ' Distance from nearest well-----_.._.__--__._-_-D�+once from nooneof6ul|6|ng-''''-_�--_. <br /> LJ Distance to nearest lot line------- <br /> ' '----^ <br /> ' Se&pug R+ Distance � <br />. -- . ~~...~~ .~.. .=" =^,we�IJ_"=�=�-u/y�nre rro �ou�� � --Distance +onearest lot <br /> ' <br /> Nvm6er of lines_---�-_-_ Length ofuoc� |in <br /> Type of filter mu+n6uL -_-'Daot of filter mo+v�aL width of trench------------------------------- <br /> ------------ <br /> Remodeling <br /> ''--- <br /> ' <br /> Remo��g and/or repairing � <br /> --'-----------------'--''---'-----'-�_^-U . .. � <br /> _ __._._-__-_-__- <br /> -__- <br /> . <br /> ___.---__..__.-___..__-__-_..-__.--..__._.__------___-__-____.-___'.______'_---._____- <br /> / <br /> ___-.___-._-._-_-.__---_____-'-_-�-'__._�_--'_-__�._ /, <br /> 'in <br /> the work wil ' '- - -~--=- <br /> be --- ` �*mr�ancew�6 San Joaquin mf | have prepared at °=-'orumancmv State laws, and rules and regulations ofthe Sari Joaquin Local Health District. <br /> ^�~ ) <br /> (Signed)-- ^ ` <br /> _ _________�_. --~^-�«.�cr�-�'�_'_._..--___'^_-._-'_pJwneran6/mn Contr � <br /> By:----__'__.______.________,______________.___-�________.. __ -` <br /> qufn��s showing^ size �t | Hm f | ` r-'---' --------------------- <br /> U / <br /> t be filed with this application). <br /> FOR DEPARTMENT USE ONLY 31 <br /> ~E"E`,E° BY DATE- ' <br /> BUILDING PERMIT |SSU ���� -' <br /> Alterations and/or ,ecnmmen6atkonm:--_-.-_`----_.---`_----'--.=--_- -� ��- �� <br /> ----------- <br /> --------------------------- <br /> ----------- ---''---'--'-------'-------'-'-----'---'----------------'----''------- ---------- ---------- <br /> --------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------- <br /> --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------_ <br /> ---`--`------------' <br />� . ------ <br /> 3--.0'�-' ISSUED -� '� �--�---PERMIT No - -(Dufe)' <br /> F|N/ L INSPECTION BY /out�'-_---_— <br /> I - <br /> T'--' <br /> SAN ~T'� <br /> ' <br /> J[���UU� L[o��LHS�LTH DISTRICT <br />\ <br /> 130 South American Stm,nf <br /> � Stockton, California ' <br />.+ ss-9-2w 9-50w�/6m \ / <br />�� ~ \ � <br />