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APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) <br /> Application is hereby made to the-San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance'with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION------'-------�_-.---_____-250 ---F�ori-dad Ave-----------StocktonI___C ------------------ ----------------------- <br /> Owner's Name------ ------------------------ -- --- <br /> Willi M. M��'l� A ------------------------------------------------g Phone----3—'x'900--------------- <br /> Address------------- 2804 Floridai Ave. Stockton' Cal. ----------------------------------- <br /> ---------------------------------------------------------------------------------------------- <br /> Contractor's Name" # D.A. Parrish & Sons, Inc. --------------- Phone-- �nn 9?-------------- <br /> ----------------------------------------- <br /> Installation will serve: Residence.' Apartment House ❑ Commercial ❑ Trailer Court [I Motel [I Other ❑ <br /> 'y <br /> Number of living units: '� Number of bedrooms © Number of baths] Lot'size--_ �:�__.X__-l� �______________________________ <br /> Water Supply: Public system ®"Community system ❑ _Private F-1Character of soil to a depth of 3 feet: Sand ❑ Gravel E] Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe)] Hardpan ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: # \� <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well------ <br /> 501 101 <br /> from foundation_._ 4_ """__-.Material_QT_1_9r?Z—_ "B�.kS.-_----- <br /> No. of compartments------.--tl�O--------Capacity��0---Q,'a1•_Size 3---- Liquid depth--- j�""""__"_"_"_"--. <br /> Cesspool: Distance from nearest well----------------Distance from foundation--------------------Lining material----------------._-----_-_--___.-__-_ <br /> ❑ Size: Diameter-------------------------------------Depth------------------------ ------------------------- <br /> Privy: Distance from"nearest well--------------------------------------------------Distance from nearest building--------------------------------------- <br /> ❑ Distance to nearest lot line________________________________________________ <br /> .Seepage Pit: } Distance to nearest well__W _1----__._Distance from foundation__"1Q_.__._""".Disfgce to nearest lot ling____ -------- <br /> 20 <br /> _----_ `� .� <br /> � Number of pits-----Pne-_------Lining material-CO. ----RlAgd: Diameter.-----3"3•_-_"""__""-.Depth-------2�_____"""-----"------- 3 <br /> fl ' 5 ` 5S <br /> ,Disposal Field: Distance from nearest well"_."�"____"-""".Distance from foundation""""__..__"_"_"__..Distance to nearest lot line___"__-___"_____ <br /> I„ ® Number of lines-__-_____Orie _"__""""_-_Length of each line__aMrox`"""70_.!Width of trench-__18-14------------------------ <br /> Type of filter material...499.gK-_-Depth of filter.material__-----21-__-____--- <br /> Remodeling and/or repairing (describe)-------------------------------------- - - - + <br /> ------------------------------------------I------------------------------------------------------------------------------------------------------- <br /> ----------------------------- -------:-,----------------------------- -------- <br /> -- --- -------------------•--------------------------- ---------------------------------•---------------------------------------------------------------------- <br /> - -- -- - - - - - ------ - <br /> I hereby certify that l have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Signed) D.A. Parr: h & Son s Inc.-----------------------------------------------------------------------(Owner and/or Contractor) <br /> Title President <br /> (Plot plans,showing size of lot, loca j n of system in relation to wells, buildings, etc., must be filed with this application). <br /> / FOR DEPARTMENT USE ONLY <br /> DATE---- <br /> � APPLICATION ACCEPTED BY------------------ -- -�-------=-------- ---------------- --------------------- <br /> `� DATEo ' f/` <br /> REVIEWEDBY----------------------------------------------------�-------------------------------------------------- - <br /> BUILDING PERMIT ISSUED_----------------------------------------------------------------- -------- DATE <br /> Alterationsand/or recommendations------------------------------------------------------------------------------------------------------------------------------------------------------•------- <br /> ------------------------- <br /> ( --- ------------------------------------------------------------------------------------------------------------------------------- -- <br /> ---------------------------------------------------------­------------------------- -------------------------------------------------------------------------------- -------------- ----- -- ----------- <br /> PERMIT No----------d'l---- ISSUED-----------1f? � F - -----(Date) FINAL -INSPECTION BY:------- 4 ---- --- ------�- <br /> Date ---------------- -----------------------: <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street <br /> Stockton, California <br /> E5-9---2M 9-50 W=1639 ` <br />