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FOR OFFICE USE: <br /> Application is hereby made to the San Joaquin Local Health District for a perm Vrr"U 4C�j;;�S'all the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. 1 to co f SCANNED <br /> Contrmcfo,s Numu-- .--_-_.---._-__.------------' <br /> Installation will serve: Residence X] Apartment House Ej Commercial El Trailer Court E] Motel F] Other Fl <br /> Number ofliving units: I-- Number ofbedrooms I-- Number ofbaths __1---- Lot size J.,PA~�. ^4-3--' -----' <br /> Water Supply: Public system X Community system [] Private [] Depth to Water Table ........ ft. <br /> Character ofsoil tomdepth of 3 feet: Sand E] Gravel [] Sandy Loam 00 Clay Loam [] Clay [] AdobeFl Hardpan C] <br /> Previous Application &4wdm: (If yeo'6ote---------- - ....) NnZ New Construction: YesX No [] FHA/VA. Yew No <br /> TYPE OFINSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available.within 200 feet.) <br /> 3"p6cTonk: Distance from noum,fwoU.I t...Di,tu from foundation-----i.0........Miu| -�� <br /> PCNo. ofcomporhnont�-.��-----.S�o �~ Liquid Jep�_-'- ---- <br /> D�posu F��: Distance from nearestweU - Ir <br /> Number Length of each <br /> Type of filter _Depth of filter material -.._Tofa| length- <br /> Seepage Pit: Distance to near alt--------------Distance from foundation....................Distance tonearest Io­t -|im� <br /> LJ Number ofp�s.-_-_--..Uning material----------------- Size: D�mefec--_-__-Depth_-_.. -----''-~ <br /> Cesspool: Distance from nearest well-----------------Distance from foundation_-----------------Lining material..................................... <br /> Size: Diameter-------------------------------------- ---------------------------------------------------Liquid Capacity............................gals. <br /> Privy` Distance from oou,e, well '--- --------------------------- -----Distance from nearest building <br /> [] D�funca +onourosf |ot |ine _'-----__-- <br /> Remodeling and/or repairing --------------- <br /> ------------------------------------ <br /> �-- <br /> ----------------------------------------------------------------- _-----_------__--'__----___--_-___-. <br /> ' hereby ^' that prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State la,w$, a.ad,,rules ald regulations of fhe/�San Joaquin Local Health District. <br /> '~g~~........^=��'^^`'=-��c-��-'u �� ---- <br /> --------------------------*-------*----------_----(Owner and/or Contractorlv <br /> -----------'----------'-------'-- -`"'"n <br /> (Plot plan, w�ewf�t �cmt�wwfoy�mm in relation to wmU� builbuildings,uetc.,. can-- bm placed on reverse'---'------wL----'---- <br /> ' <br /> 4 FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY ' _----_._-__.___--' D�TE -e/ -� <br /> 12- <br /> REVIEWED DY_--_____-_-_---_--'--_-'---_'-----------_- - '--- <br /> - e^c-.------- <br /> BUILDINGPERMIT ISSUED--------------------------------------------------------------__-------------------------------------- <br /> _- '-- ---------------------------------------- <br /> Alterations �� <br /> � <br /> -____mn6/mr _�~_._ <br /> '-__.----_-___._~-.~-~._- -_--__ _a°�� <br /> _ <br /> ---.__----------___-_-----.___------___-._-----_~ <br /> _ <br /> _-__-._-__-__-'- <br /> --.__' <br /> __-.---_-_-------.------_--------.------.__----._--_-_--._.__.--_----__.-__. <br /> -----''---------''''''---'---'--''-----------'---'-- '—'---''-----'--'-'-''''' <br /> HNAL INSPECTION -_.-------------- Date-. -'-.��-.-r'�----------___--_. <br /> SAN JOAQWNN LOCAL HEALTH DISTRICT1�x��°�o� �W��n� 1z*��ou�W��o�n���n California Lodi,California California <br /> ca, Tracy,California <br /> c° pREVISED o'vn2wy'o1ATLAS <br />