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' <br /> APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) <br /> Anolic«fionfis heis made in reby made to the San Jouq�nLoc� Health District for o permit +oconstruct and ln�a|/ i�e�or� �e,ein �e i� � ' <br /> compliance- - with County Ordinance oncv m' 549. ' �cr e . <br /> JD <br /> ,.g Apartment House Ej Commercial 0 Trailer Court 0 Mofel 0 other 0 <br /> Water Supply: Public system k 4 <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam 0 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: Clay Loam 0 Clay El Aclobex Hardpan E] <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) .", N� <br /> Septic Tank: Distance from nearest well--------- ...Disfance from foundation------------ <br /> Cesspool: Distance from nearest well <br /> -------Distance from foundation--------------------Lining material <br /> Privy: Distance from nearest well <br /> Dis+ance,fo nearesf lot line <br /> Soe n Pit' Distance to nearest well---777��Distance from <br /> � ��� ^' ` <br /> Distance to nearest lot line _x <br /> Number of pits-'_ Y <br />'-^ uu,pqs /-�e� D�fu -----��-' °eprn-�c�u�r� <br /> Number of lin6s --- <br /> Remodeling and/or repairing (describe). <br /> --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> the work will be done in accordance with San Joaquin Coun <br /> I hereby certify that I have prepared this application and that <br /> ordinances State I and Ares and regulati ns of the San Joaquin Local Health District. fy' <br /> "(Plot plans. showing size of lot, 9_ng�_ ------- <br /> location of system in relation to wells. buildings, etc., must be filed with this application). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY <br /> ----------------------------Z <br /> uu|Lo/NG PE---R---M/T /3SU2D .______�-''--''---------' --- <br /> --_ uA|E-_.._��____'..__.�� <br /> AKm'mtonswnJ/ur ,mcnmmon6aHon»-_______�_---'--------------- DATE- <br /> -------------------- <br /> ---- ( <br /> ____.-_.____-..___.----..__.-_..__.--_-.---''''_--''-_.'-___---__-_-__-.--_-__----- - ----------------------- <br /> --- <br /> -- <br /> - <br /> _-____ �-------- <br /> ----- <br /> '''__.''__.-- ''-_.'--__.------- <br /> ' <br /> ES- <br /> _.__..-r---------'''__.__.____..___.____.____.__._____._._____---------- <br /> '---'---- <br /> --------------- <br /> ---------------------- <br /> _ <br /> ---- - <br /> -' --- --- - --- - ---- ---- ---___'-__----__'-_-- ---__---__... - - - --- - -- --- - - -- --- --- - <br /> PERMIT No-A0 7 |SSU <br /> ._--- �~_-°�, �/ c �� � --_(OoteRNAL /NSPBCT{}N <br /> Uote'_-'''-- �-' <br /> ~ /' ' � `^ / --r--'---' <br /> SAN JpAQU|N LOCALHEALTH DBTRC7 / | <br /> 130-SmufhAnner|manSteef <br />