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_ <br /> �-��-----� Permit No �_jF�'^� � �� <br /> APPLICATION FOR SANITATION PERMIT <br /> (Conop}ofe in Duplicate) Date o,neo ---- <br /> /' ~ \� District for o permit to construct and \n���n�6 her -���' <br /> Application is hereby 6 to +hmSunwith County,ordinance No. 549,e <br /> Jouqu�n Local Health <br /> This app;icat-ion is made in rompliance e-Z I-, ---------_6--- ---- <br /> JOB ADDRESS e�D LIOCA N_49-,--,5- -- - ------ <br /> -------------------------- <br /> Number of living units: -;I---4umber of bedrooms ---/--- Number of baths ----L Lot size --- ------- 16- ----------------------------- <br /> 4;_ 'El Private C] Depth to Wafer Table -------- ft- <br /> Water SuPplY: Public system community system Cl L am [I Clay 0 Adobe�/Hardpan 0 <br /> Character of soil to a depth of 3 feet: Sand p Gravel [I Sandy Loam P ay 0 . <br />' Previous Application <br /> \C�J\��wS <br />� TYrEuFxv=.A^^..._. ' is availablewithin ~~_ ._` ' <br /> permitted if ublic jsew r <br /> (No septic tank or cesspool ur ... 4)- <br /> u �anco "`"" .~.`_est '_ell <br />� ��p`.` <br /> ��| ' istance from found <br /> » No. of co ation ZJ-------Distance to nearest lot line <br /> � Total length---- <br /> Pp�^ Field: Distance-- engfbp« *��' ^'~^ --' '1�LL <br /> � ^~ Type of �ter mo�* ��vm`�s~�''`�^ ~~p- lot |� <br /> ce from foundation--------------------Distance to nearest <br /> ! y» u'^',"^~ to nearest— | Size.' °'a"'~'~' ----- Depth <br /> Distance + nearestwell Distanceuqu/� �up"�', --'- gals' <br /> � Cesspool:- Size: Diamof��. Depth__ <br /> El <br /> � ' <br /> na� u` -- <br /> ---------------------- <br /> Distance <br /> ~.~~ <br /> Phvy: Distance to nearest lot line �-_-'___'---'''__.' __.____ . . .-----__.__ <br /> . <br /> - <br /> __ ' __----- - __ <br /> Remq6��g and/or repairing (6u,c�be %-_------'__'.- ____._______._-_____.___..______.__ <br /> `'-___--__---.__--___.-_..-'__..___.._-__ . -___._.__-_--------------------------------- <br /> __-- <br /> ----- --' ---__'___.--__..___.. <br /> .____' <br /> is <br /> -----------------''---- __-----''--------'---------'----''----_-.-___-_ <br /> ---- ---- mnd that the work will 6odone in accordance with Son Joaquin County <br /> — <br /> application <br /> I hereby certify1hat I have i s off the San Joaquin Local Health District. <br /> S r <br /> � <br /> e.- <br /> (plot plan, showing size of lot, location of system <br /> FOR DEPARTMENT USE ONLY <br /> ---------------------------------------- <br /> ' BY <br /> ! xEv/c,vcu BY -' _ <br /> � <br /> ^ <br /> / <br /> Q ------------------- <br /> r--- <br /> I-------------------------------------------- --- t ------ -------------------- -------------------------- <br /> ES-9-2M na/ x""is"« vv-2/00 <br />