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\n <br /> ���APPLICATION��APPLICATIONFOR SANITATION PERMIT <br /> �����D[ m ' <br /> �� Duplicate) <br /> "J | ^� -- *-�-IFF� �)� (Complete <br /> b ~ '�or 6v made to the Son Joaquin Local Health D�t� for� o permit to construct and install the workherein described. <br /> This app <br /> �rp"°"'|'�/co^tion |� ".�do |ncnm.�iano: witkCoun+y {}n6innnce No, 549. <br /> JOB ADDRESS AND LOCATION_____� <br /> Phone- <br /> Contractor s Name---AA <br /> i Other El 00, <br /> Installation will serve: Residence Apartment House El Commercial E] Trailer Court E] Motel [I <br /> Number of living units: Number of bedrooms I Number of baths / Lot size----, <br /> Private [] <br /> Water Supply: Public sysfemIRr Community system El an <br /> ' <br /> Characterm. ^nx "' � °=r' of ~ feet:— --'- ^~ -- <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public'sew�r is available within 200 feet.) <br /> Septic Tank: Distance from nearest well--v Distance from foundation----/0--------material---- - ----- ------ -- --- <br /> lap <br /> Cesspool': u.u"= from ..~.~~. well'---- ------------ <br /> �o ,e, well Distance— -fro- nearest- - <br />^ . .,, . <br />. Distance to nearestlot � <br /> st Dis ce from foun ion---J_-0-----------Distance to nearest lot �ine <br /> at <br /> Rion---------------------Distance to nearest lot line----------------- <br /> LJ Number of lines'----'-----------------Lengthof ��* material Type nf1�termu{e�uL'�-'''-__.Vepm ' -�'-----^' <br /> ` , . <br />` �emo6��g and/or papo|�ng �oo �6o :--'''----�'_____�---__._'_____________�____________________ _ <br /> � .____�_____._-__..__'_--__-_-__�.--�_---__-_--.--_-_-_---._-_-__.-..__� -_. <br /> « .._-- ._-..__-_-_--_.--'_-___-___-'-__-_'�-..�=�����__._'-_-_--____.___'_---__-- `- <br /> . .-_��-- ` '''--____----_�-._-__--'_..___._-._.__ . <br /> ---------'--------''-'---'-------'-an�'yha� +�e �or *U 6e 6nnw in amnnrduncew�h San Joaquin County � <br /> I hereby certify that I have prepared this application <br /> ordinances,^ ~ State laws. D~~ <br /> uin Local Health District. <br /> v <br /> ' � <br /> / _-''''----_-'''''__.-''''''^., ---_ <br /> -- <br /> By: '�at�nh»�mU� buildings, ef�. -- <br /> must be fi�6 *�h +�m application). � <br /> �k` n�nvsho*�gmmocf�t �cannnxx �~`=. ". <br /> �� <br /> DEPARTMENT USE ONLY <br /> -----------� D�T�i-.. <br /> /\PPUCAT|(3N 7ACCEPTED 8Y' -----�-_---'_- �-- ^ -_'�----_- --'-'--��__-�--------------------------- <br /> DATE.KEV|E\�BD BY'---___--__--_-'''`-_-_'-----''-'-'-'�-' ___________��______ <br /> DU|LD|N<� PERMIT |36UED.'___'''-'''--_-.-'---_'-_--_-'---'''�''-_'- DATE ________________ ------- <br /> Alterations <br /> __- <br /> AhnruGwnsand/o, n»w*mmmonda�wm�--.-'`------_---_-_-_---_�_-._____________ ___._____________.__ +' <br /> __--_--_-__.--__---.__-..__'__--__--._-_---__--__- � _.___--.__----_-_-._-__ <br /> _'------.'__--'_-''__-''''-__-'''--�-'-''''-_-''----'''-_.'''--� �-._----__---_.. _-''-'-'--- <br /> . _-'_--_--'_-_-.-----_'_--__--.___-------._-_---� �--�� -_--.___---..__-.- _' <br /> -'-'----''-_''--'''''-------'�'''--'-'''--''''--' ''--'-'''���� ^ ` � , / +~� J��~ <br /> � `�-^ �� /�� <br /> PER��|TNo-.. -- |S�UED-��~.t�r���_-----U}ufo),F|N/\L |N�PBCT|[)N DY:--.. -------------------- <br /> ISSUED <br /> _____. <br /> ' Dofo-_--'--r�----^`--''="-�f----- <br /> Am JOAQU|N LOCAL HEALTH DISTRICT <br /> ' <br /> 130 South American Street <br /> 'Stockton, California <br /> ES-9-2M 9-50w�/639 <br />