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' ' <br /> ' . SANITATION PERMIT F�� SANITATION �PERMIT Parn� No ,�~.—�-�._e' . <br /> � Oun�a�) <br /> r~~^'r'~'~ . Date |ovue6 <br /> Application is hereby made to the Sun Joaquin Local Health Disfr|ctfor o permit toconstruct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. ' <br /> / / <br /> 2\0A� CIL <br /> JOB J�38 /\DDRESS AND U3(�/\T|C)N--------_,--.-��-' ��/��� --_'^���..`--------_---_-.--------.�� <br /> /- ---�` ����/�_y~(_______.___.____. p�onu__���.�7����-,' <br />� — '---''---'----^dorvo�_- _ ��-r�`�-"�- -"==44. ----'-'--- <br /> Con��cto,, Nom�''--'-''' '''--�---''--_-'-'--.-'''-_-''-''-_''--_-' Phone <br /> . '--�— <br /> |msta|lation will serve; Residence 5� Apartment House L] Commercial Trailer Court 0 Motel E] Other 0 ^- <br /> Number ofliving units: -------- Number ofbedrooms ----R' Number ofbaths /- Lot size -----------41}------ -------------------- <br /> Water <br /> ._--.--Water Supply: Public system b� Community system El Private F-1 Depth to Water Table -------- ff, � <br /> Character of soil to a depth of feet: Sand 0 Gravel [] Sandy Loam [] Clay Loam 0 Clay [] Adobe Hardpan F] U <br /> Previous Application Made: Ye, E] No K Nev Construction-. Yes E] No [] v <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> /No septic tank n, cesspool permitted if public sewer is available within 200 feet.) <br /> Septic <br /> .Tank: Distance from nearest well Distance from foundation--------------------Material <br /> DisposalU-- ��-- - <br /> Field: Distance from nearest w� . �Di,fnnc� 1,um tovndo+ion -�.2�e_ru/,tunce to nearest lot o --��- _ <br /> nv . . � <br /> �� <br /> Number of linesLength of eu�6 line #_V 12 VdH` of �ench�� � �^"._---.._ ~" <br /> fl <br /> 3enpoge Pit: well Distance from foundation Distance to nearestlot line ` <br /> [l Number of pits Lining ma+o �- SDiameter--- Depth <br /> ---------------------------------- <br /> Cesspool: Distance-__ from nearest well'-----------------Distance from foundation -------------------Lining <br /> El Size: Diameter----.-_-----Dept h-------------------------------------- -------------Liquid Capacity-: | <br /> Privy: Distance from nearest well---''''-''--''''--'-Distance from nearest building <br /> E] Distance to nearest lot line----_---------_-------__--__-----�--__-___-_._---_- <br /> Ramo6eing and/or repairing (describe): <br /> I herebFc fify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances. ta e laws an, ruIes,4ncL,5,e I f the San Joaquin Local Health District. <br /> (Signed)-- --- -------------------------------------------- <br /> ' . . <br /> 1 Popan. ��� seofhooao 'oyem nmaoo wesbudgsec. oa6eca--c----d---osv-------e---s6e <br />� <br />{ <br /> FOR DEPARTMENT USE ONLY <br /> / <br />' ^^`'^``"' "'--''---'--'---'-------- —'���~`'--'`'^-----'-'--'--- DATE----' ''--'--7^-------'' <br />� BUILDING PERMIT ISSUED----------------------------------------------------------------_.''''__''''''--' DATE------------------------ ------------------------------------ <br />' '--_ <br />� .. <br /> --------------------------------------------------------- <br /> ' -- -- <br /> -._. ________ ---------------------------------------------- <br /> --'-���L_'�_---------'_---_--_..\l-..-_--�-l----------------------------------------------------------------------------------------------------------- <br />| <br /> HN/\L INSPECTION BY:' Du�------------------------------------------------------------1 / '---'^''-'''--'----'''-'''-' '--._---. <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /uu South American s*=.m 300 West Oak Street mx Sycamore Street ow N"*k ^o'' Street <br /> ` <br /> smoktv". California Lodi, California . Manteca, California rmov. California <br /> 0 sS-9-2w 8-5/ ae.�se6 v*e|no <br />