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J�FOR OFFICE SE: <br /> APPLICATIOWFOR SANITATION PERMIT Permit No. <br /> !I Date Issued <br /> A- lication is hereby made to the Son Joaquin Local Health Dist rict for a permit to construct and install the work herein described. <br /> is,application is made in compliance with County Ordinance No. 549. <br /> Owner's Name..........A ` <br /> � ' . <br /> Colltnacto,'s N -------------.-------_— phonm_'—.--....----.—'. <br /> i will serve- Residence 0 ,Apartment <br /> ~` ^ Commercial E] Trailer Court C] MotelO Other 0 � <br /> � � <br /> Nom6erof |i�og units: J---- Number of bedrooms ��� Number of baths +'-' Lot o�, _"�_- ------' <br /> � W�r-- �wp�k�� Pu6||� system u�'^��o.�nou�fy system El P�vofu El Depth to Water Table -------- ft. <br /> Character of sail to a depth of 3 lost: 'Sand E] Gravel [] Sandy ` ^ m 0 Clay Loam 0 { lay[] Adobe�—_H_ _ n � <br /> Previous� Made: Ufyao 6om^---`_'j Nn /�� " ` : YmsnT~1`� [] FHA/VA. Yew []- No L] l <br /> � . <br /> TYPE <br /> Of INSTALLATION AND SPEC|PkCATk�NS � <br /> v U (No septic tank �r ��o�»�pi permitted if public sewer lu available within200fmet.) <br /> , <br /> 6a nk: D f || '--- D/ t to ^' Material+ai | �����1���' ^....... ^ <br /> , ' '�lw� ��� 7 -�, <br /> Di, |o|6: Distance from t well --- Distance from 1 6 H Distanceto eanost1ot |i� ' �......... ' <br /> 51— <br /> Type of.filter nnmto� +i* <br /> oL.+�������—Dnpfh o+ wr material------ |engm----��'��—.'...—.—Se6pa(ge Pit: -- <br /> « n <br /> 0�� .h, xa*mwt U ---- D�+un�� fnzn�fou D�� to n*� lot |i ~ <br /> Number of murorm�zY�e�c�—'uua: u/mmorn,..^z^?—_--Depth ..'��c�=..���c.ceispool , <br /> ` / � | <br /> : Distance from no*,eo weL_-_._Distonco from foundation—_----Lining muta,iaL_-----..--_.— <br /> )[] ' Size: Diamatuc ''---'—''---'--Deo� '--''---'''—_''__Liquid --------__g�� � <br /> ` � ^ l ` <br /> Distance from nearest n�L'—''--'--.''--�''--------Distance from nearest building'--------'__.--'— ^ <br /> - D|�anco >on*uros �t |ine—_--_--_—_.. <br /> Remodeling .^=,.._--._--_----'-__--.___-_.____—____ <br /> - <br /> e�o .��ing onJ/�r repairing �a�����----__---_-----'---_----------_--_.__—'_----.—.--.---..—....—.__.. <br /> � � � <br /> —�-------___-_--_—_—_______-.—.—___'—_..____--_____'—_.—'--.'_—'—_.'--_.'---.'_—'-- <br /> ------------------------------------------- ........---..--.--�_.--__-___--__.__-_—.--_.............. <br /> - <br /> ~ ` ) - - � � <br /> '�. --' ---' --'-----------''--'--'—''—'' <br /> � | hereby certify thatI have prepareldth& application av6 that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws. and ,o|em and regulations of the S�ihJoaquin Local Health District. <br /> � <br /> ri�/or Contractor) <br /> (plot plan. she ing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> �`rru^~~�//um ACCEPTED m/--.*r��.--..�.f..�'�.�-----�.—'----.-_-----'-- ""'=—'`+`- --'z ---- <br /> REVIEWEDBY----------------------------------------------------------------------------------------------------------------------------- DATE-----------.-_---_-----. <br /> BUILDING PERMIT ISSUED---------------------------- <br /> --------------- <br /> � <br /> FINAL |NSPE{�T| �� _��� � —��_, ---------------------­--. ___ <br /> �t�. �'-/*- --c��' <br /> �. �� - _ -- - - / <br /> k v �������U�� ����LHG�LTH DISTRICT <br /> V , <br /> vnwSouth�riccinStreet 300 West Oakvirsel 124 Sycamore Street 205 West 9th Street <br /> ' <br /> Stockton,California Lodi,California . Manteca,California Tracy,California / <br /> o <br /> m9REVISED "°° nw ".", All-AS ` <br />