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APPLICATION FOR SANITATION PERMIT Permit No. (Complete' ` �— Duplicate)— ` Date Issued �_- -� - ' Applica-l'ion is hereby made to the San Joaquin Local |+h for a permit to construct and installthe work This application is made in complianc6 with County Ordinance No. 549. JOB ADDRESS AND LOCATION----- ------- --Ij 16--ri------�=---�Po_jrla.7-------------------- --------6----------- 01 f Contractor's Name--------------R�� -----_. ------------------------------------------------------------------ Pho ...... Installation will serve: Residence 3--"Apartment House E] Commercial E] Trailer Court E] Motel [j Other Number of living units: ---'J- Number of bedrooms _J. Number of baths _/--- Lot size ---------- Water Supply: Public system le-6--omaiiihify system El Priv.ate F-l Depth to Wafer Table ff. Character of soil to,adepth of 3 feet: Sand Sandy Loam E] Clay Loa [] Clay E] Adobe ��urdpanE] _'~^�� Previous Made: Yes E] 'No �� ma* Construction: Yes E] No r �1�I INSTALLATION AND .. 2 1 Io septic tank or cesspool permitted if public sewer is available within 200 feet.) ic 41Lf No. of compartments..........................Size--------------------------------Liquid dep�h---------- ---------------Capacity----------------------- OS41 IN Distance from nearest we�l...... ----------Distance from foundation--------------------Distance to nearest lot line------------- |ype of m+e, material-------- ----- .'uapm of mme, material-----------------------Total length C� 3 Distance wu|��jl��. D�� t �� Number ofpits-.'-/--------------Lining ma+e,io| -----Size: Dk,me+or ��^ -.Deofh-Z-,V^----'-. -� Cesspool. Distance from n0�s �eL'_--'Distance from foundation mo+o,�L'-''--'''---''- V) [� Size- D�me+ �-]�----------Deof -----------------------------------------------------Liquid Cupuc��-.-�-_-_---.go6. . l Privy: Disfon�r from noq,o,* we'll-------------------------------------------------Distance from nearest building------------------------------ '-'- El Distance to nearest lot |�n; ----- ----- --------------------------------------------------- ------------------------------------------------- =�~ Remodeling and/or repairing (describe)-'-'--'---'--''-'--_''__._--�--_-''--'-_'__---__'_-'-_-_-'-''-- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- '--'-------------'-------'----'----'---------------'---'---'----'---'----' I here c rfify at have pre Pa'e ation and that the work will be done in accordance with San Joaquin County ordinanc la S, I an re the San_jparquin Local Health District. (Plotplan. showing size of lot. location of system in relation ellso ildings, C., can be P�,�ed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED 8Y-----_------��----�- ----_--_-.-- D�TE—.. 5_5~______ REVIEWEDBY'''-'-'-''-'''-_'--'-'_''--'''-- ----------------------------------------- DATE------------------------------------__________ BU|V)|NG PERMIT ISSUED'-'''-_''''-''-'''''''-'''----''''-'''-'''-'- DATE'---.'''-_-'-'---'--_-'- Alte,ufionv and/or rocwmmon6af ions:-------------------------------------- ------- -_--'_---_---'--___---__-_-'--__---__---_. Dyw Aes," 'u �c:. / ~ ------------------------------------------------------------------- --------- | ��_��__��_�__��___��__---- ------------------ --------------------------------------------------------------------------------------------------- --------------------------------- / '--'---'--'''--''---''--''-'-'--'''--'''-''--''''-''---''--''---''-'''--'--'—''-'-----'-- '-----''--''''-''—'' '--'''-''''-''--'''--'-----''-----''-''-'-'--''--' �� RN/\� INSPECTION 8Y�-- ==��----.—. Dut�--..��._-..�-------- -------------------------------- ` ' SAN JOAQU|N LOCAL HEALTH DISTRICT /m sv"m Arn°ric-a" Street \ 30D West Oak Street /sz Sycamore Street mw North ^o^ Street Stockton, California Lodi. California K4wn*vm^. California Tracy, California . . ' ^S_"_"" .°°°^`"OO" .2-54