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x <br /> APPLICATION FOR SANITATION PERMIT Permit No.�-/ �t` -Z— <br /> (Complete in Duplicate) <br /> Date Issued <br /> Application is hereby made to the San Joaquin Local Health Di <br /> This application is made in compliance with County Ordinance NoG549r a permit to construct and,install the work herein described. <br /> =� <br /> JOB ADDRESS AND LOCATION---_-_-- 1010 So, David Street <br /> --------------------------------------------------------------- <br /> - - ------------------------------------------------------•--------•- •------------------------------------- <br /> --------- <br /> ----------- - <br /> Owner's Name------------------------------ Emil. Vigolo ----- <br /> --------- 3-3689 <br /> , <br /> --------•-----•-------------- ---------- ----------- Phone----- ---------------- <br /> -----­--------Address -- � Same ----- <br /> --. <br /> Parrish Inc,Contractor's Name------------------ ------- - - - - - -- 9�g6Q7 <br /> -- =--------------------------------------- <br /> installation will serve: Residences Apartment House ❑ Commercial ❑ Trailer Court <br /> ❑ Motel ❑ Other ❑ - <br /> Number of living unifs:l*-_- Number of bedrooms --3--- Number of baths 1----- Lot size __-_-100_ X 100 1 <br /> Water Supply: Public system <br /> E] Community stem <br /> - ­------------------------- _ <br /> Y s Y ❑ Private [X. Depth to Water Table -40_ ft. Plug <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam [] Clay ❑ Adobe 49 Hardpan ❑ <br /> Previous Application Made: Yes ❑ No M New Construction: Yes ❑ No ❑ Supplementary. Drainage <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: -g <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) �. <br /> Septic Tank: Distance from nearest well-----------------Distance from foundation-------------------- <br /> E stJ Is Material_ ------------------------------- <br /> No. of compartments °----- ---- --------Size----------------------------=---Liquid depth----------------- <br /> s Capacity - <br /> Disposal Field: Distance from nearest welL.-0 ___-_._Distance from foundation-AQ-__---_____,pistance to nearest lot line___j-0a <br /> Ix Number of lines-------- -----------------------Length of each line-------_ <br /> n �a,r ' <br /> g -18�t ---.Width of trench- - -� --- ----'=��--- <br /> Type of filter maferial----- -----R_k----Depth of filter material---_--_ <br /> Total length------- Q <br /> eepage Pit: Distance to nearest well--- �0�--_ :Distan fr m fo&dafion_�'©_'-__ 1.0 t <br /> Distance to nearest lot line-----.-_----_--- <br /> 1 EX Number of pits------_--1-___-___--Lining materia- �riC p <br /> ----------Size: Diameter-------3-3.----------Depth----25 <br /> ------ --------- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation_-.----------------Lining material-----.------ <br /> -_.---__ -------- <br /> .__ <br /> Size: Diameter---------------------------------------Depth_---------- --------- ---------- - ---- -----------Liquid Capacity-- ---------------------gals. <br /> Privy: Distance from nearest well------------- <br /> ------ <br /> --__ - __ - <br /> t <br /> - ----•-------------------_Distance from nearest buildgin ., <br /> Distance to nearest lot line__---__-.._---___---_--.--_ -' <br /> ----------------------------------------------------------------- <br /> Remodeling and/or repairing (describe)---------------------- <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin <br /> ordinances, State laws, and rules and re ions of the San Joaquin Local Health District. County <br /> (Signed)---------------- PARRISH <br /> ------- ----- ----------- --- <br /> -=------ - - ---------------------------------------------------------------(0BY- - r Contract <br /> ---- ---------------- - ___ Estimator or) <br /> (Plot plan, showing size of lot, cation of em in re n to webs uildings, etc., can be l placed on reverse side. <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY------------- -- ---- -- <br /> - --------------------- -----------•-- DATE - 1-- <br /> REVIEWED BY----------------------•--------------- - -- • --------- <br /> ----------------------------- ------ DATE------- <br /> ----------------------------------- <br /> ------------. ---.---. -- <br /> BUILDING PERMIT ISSUED-----•------------------ -- ------------------------- ---------- <br /> -- -- ------------------- <br /> ---- ------------ -------------- DATE----- -------------- <br /> -------------------- <br /> A terafions and/or recommendations:----------------------------- --------------- ------- ---------- <br /> - <br /> FINAL INSPECTION BY:.---_---__-_WV - --- - ----------• --------------- Date----- - <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street <br /> 132 Sycamore Street 814 North "C" Street <br /> S+ockton, California Lodi, California Manteca, California ' <br /> Tracy, California <br /> ES-4-2M 10-52 Revised W-2100 <br />