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, <br /> APPLICATION FOR SANITATION PERM[[ ` <br />� . <br /> (Complete in Oupiicate ' <br /> Application is ena6v made to the Son Joaquin Loco; Hoo|H` District for o permit to cons�rucf and install the work herein described. , <br /> This application is made in compliance with County Ordinance No 549. ' <br /> r ` <br /> JOB ADDRESS AND LOCATION <br /> Installation will serve: ResidenceK Apartment House E] Commercial 0 Trailer Court Motel Other <br /> Number of living units: [Z -Number of bedrooms j Numberlof baths 6-tof iz�----- ----------------------- <br /> Water Supply: Public system 9 Community system 0 Private E] <br /> Character of soil to a depth of 3 feet: Sand E] Gravel Sandy Loam [:] Clay Loam Ej Clay Adobe E] Hardpan E] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool.permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nea'rest *eL-_-._�'Distance <br /> ^ from foundation--------------------Material_-__.-_-''''-'____- ~ <br /> [] No. ufcompartments--------------------------Capacity-----------------------Size-----------------------------_Liquid 6mot -_-----.--- <br /> / ' <br /> Cesspool: Distance from neona� weL-__--�istu from foundation Lining materiaL--,''''-'''-'''- , ~~ <br /> [] Size:`Diameter-__..__--__--_Deof _.-�___.----__-.__ <br /> \ ^ - <br /> Privy: Disfancefrom nearest well-------------------------------------------------Distance from nearest building.'-''--'�_�_'-_-'- \ <br /> ° 0 Distance tonearest lot line`--__.--__--__._-- <br /> Svvpo *tDistance to nearest n°/7d,7_*? u �o � -�n���_� u nearest / ------------ <br /> Number <br /> ~~ <br /> n noror Pnn__ ! Lmmg �or�r/o�°��A64----Size: u/*mc,e"-~�~ .. "ep,"_ <br /> --,-- Field:- Distance from - 11 <br /> K- ^ <br /> Ally 0 <br /> ------------------ <br /> ''-__---____-__----._�-----..___.--___.---_.-�--__._-..___.-----__..__..__..__.___-_____' <br /> | hthat | have ' ,ed this application and that the work will be 6nno in accordance with San Joaquin County <br /> ordinances, State laws," "' '- <br /> P\rm, p/un� pn � <br /> `~. <br /> � FT DEPARTMENTUSE ONLY <br /> APPLICATION ACCEPTED ~'---------- -------—'r~°~'°~"'--'-------'------ - 'AE-----`-'---------'----- <br />� <br /> REVIEWED BY------------------------------------------------------------------- DATE------------------------------------------------------------ <br /> BUILDINGPERMIT ISSUED------------------------------------------------------------------------------_'''''-'-- u*|E--'-_-.''�----__--_.--_-'- <br /> Altwr*tionsmn6/orrwcmmmnnJaGuns --_---_-----_------.--------------.-___._-----_-----__.-____`___.__ ` <br /> ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ --------------------------------------- <br /> ----------------------------------------.--_ ----------------------------------------------------------------------------------------------- _--..----------------------------------------------------------- <br /> -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> __.'---__ <br /> ._-__-____��_-' -___.. _-. - -------------------------------- <br /> 7Z <br /> _-_--���-_ ° <br /> PERk�|T N��_�!�����.. ISSUED -�_-_(Da*� FINAL INSPECTION BY.--* ___-_- <br /> Do+n_.'''-_------------ ''__.-_-- <br /> SANJOAQU|NLOCAL HEALTH DISTRICT <br /> ! <br /> 130 South American Stnya+ <br /> Stockton, California <br /> ES-9-2M 9-50 W-1639 `-__ <br />