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' \ <br /> APPLICATON/ FOR SANITATION PERMIT , <br /> (Complete in Duplicate) <br /> + <br /> ^ ~ <br /> ` n6 install the work herein described.Apn|lcntion i, hereby made to the Sa.n Joaquin Local Hon|H` District for o ponnittp constr6c+ u <br /> This application is mo6o in compliance with County Ordinance No. 549. <br /> �� � , <br /> J[>B ADDRESS AND ��C�T|{�N--_-» ..��-o�----.C��../-.�'s������.. -------------.---'_---'`---'�----'--' <br /> '------------ <br /> Phone ----'--------- <br /> ------------------------------ <br /> Owner's <br /> --'- <br />' Ow � m <br /> - <br /> - <br /> Contractor's Name-- --------------------------------- <br /> ~ ''---''-�''�--'''--'''------- Phone-~^--- <br /> - <br /> ------ <br /> )n�mUa+wm will oen/n: �os�e»ca - �ApurfrnontHoum: E] Commercial 0 Trailer Court LJ Motel [ ~*H~, [] <br /> ^ <br /> -.. ` <br /> Number of living units: � ' Number of bedrooms C� Number of baths [Z' Lot size--------- -'~ � ^ &~ � .' ' <br /> Wafer �]+ <br /> ����: Public ��m x <br /> Community systemEl ���` - . ��~'' ' ~ <br /> � �o6o � <br /> Hardpan <br /> Character of m@ to a ��� �3 � �n6 � �� � Sandy ��m � � 'o�Q ��' O� [� <br />' TYPE OF | ��� ������ONS: - ` � � �� <br /> 'm`'~^��"=- � 6Um � w�6� 2O0feefJ ' <br /> (No septic tank or cesspool permitted <br />` nk� Distance from nour*` well - ---------»/'n�"= """' ' '~^'-----' ' |6 Je�th.._����'��- - <br /> / ---------------- <br /> Septic �- ���n+�_' -��� ��p�cMY�_���� -_�p"__=.._�_~�-_���� _ <br /> No of compartments __- ' <br /> �� ' '''I-�--'----�� Capacity-!from foundation-------------------- <br /> --___Liing material <br /> ------------------------------------- <br /> Cesspool: <br /> ___._.----__._ <br /> Cu"n000 � Distance from nnony� waU__.-__D|�*nna <br /> Size: Como+or-�--------------------------------Uop+" . . '''---ouros+ 6ui|�ing-,--_---_--_-_-- <br /> p�"y:' Distancefnom nearest well Distance from n <br /> -__' <br /> 45��- Distance to st �tVno___' . � <br /> �� Distance *» nearest or xn°- <br /> _Seepage p�: Distance to neoremwr/'-_--_--~...~ _ <br /> ` _Numbar of p��- Lining material ~-- Diameter_ <br /> DiF��: D�tonco �om re' wo '-m '-�� Vyi�+ of �onc6'-_���Z�' ----------- <br /> Number <br /> ---- <br /> � '���� Num6nrof linesLnngm of each xn=_'_-^ .� <br /> T� � 5�r m��. _�� � �|�r ��u|_-��_. <br /> ' '. <br /> ^ ` . -------------------------------------------- <br /> ------------ <br /> � --______'-�__.-_---.__..__-_---_'�__'-- <br /> Rnmu6o�g and/or n,po/�ng �vsonue>�-_--___'''-_.---_'__-�. _ ���� _���������_��__ __�.____.____ . <br /> � -_.-_' _---___�-..___-__-____--___--__-__---'_---__-_-----.-------------__-_- <br /> -_-----'---_--------.-_-----��-_-___-_..___..___��� ._-_----.-_----------_------ <br /> certify ^ ave--�---'-------'----------'-''---'------ '� ��h San Joaquin County <br /> ---------reby-----''H,'--|'--' ^ ,e6 t6� application and that the wo, *U be done in accordance <br /> at <br /> � w,="="c°° ~ laws, -- rules <br /> (Signed) ^ '''�-_--''-__._- __-_--_---___''-_'--'-- <br /> -�----^''--`'''-- '- �u� 6e ��� *Kh +6� <br /> � R��f "x^-'---�--�---'lans, showing size of)o+ |ocu�on *foy6em &nnwla�pn+owoU,. 6W|6|ngs. ot�. �p�°='~~r <br /> FOR DEPARTKAENT USE ONLY <br /> r -- �T| ]N Br <br /> � � J� FINAL |NSPB <br /> PERMIT No' - - |6SU� h ' <br /> . <br /> - SAN JOAQU\NLOCAL HEALTH DISTRICT <br /> 130 South American Street <br /> ' �� ` ~ ' $fmckton. California <br />