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FOR OFFICE PSE <br /> ^� C.����N~FOR -�AN�A���N 'PERMIT Permit No.- ----- ' <br /> (Complete in Duplicate) Date Issued / <br /> '--Application-is-hereby..made to-the-San-Joaquin.Local..Healfh..District,for a permit.fo�cons.truct,a_nd instaIll the w-ork-herein described.� <br /> This application u |/ with County ' <br /> JOB ADDRESS AND L C TION_ <br /> Installation will serve:-'Re'iide`nc­e­Ej,,Apartment House Comm Motel 0 Other L] <br /> ,Number of living units: _,57 Nu M' ber of bedrooms NumlD"ef-��fbaths Lot size --------------------- <br /> Water,'Supply: Public system-E)-1 Community system [] Private Erbepth to Water Table&749 ft. <br /> Character of soil to <br /> of 3 feet: ,Sand E] Gravel E] Sandy Loam L] Clay Loam [] Clay [3 Adobe"ardpan 0 <br /> Previous = (if yei'date--------------------) No [l New Construction: Yes [] No A/VA. Yes [l Nn [] - <br /> ~ . . <br /> TYPE OF |NSTALLATKON~ANO'SPEC|FICA?N3NS: <br /> (No septic tank or cesspool permitted ifpwbric sewer isavailable within 200 feet.) <br /> Di,tonca'from'noa,es+ well-----------------Distance from foundation--------------------Material -----. ............................. ' <br /> No.'ofcompartments--------.'Size................ -------------- Liquid daA+h---------------- ---------Capacity....................... <br /> Distance fnom'oeunest well —-----------Distance from foundation....................Distance to nearest lot line................. <br /> Number of |inis------------------------------------Length of each line------ .'-_.''-''_Width of trench................................... � <br /> Type of10lfec;nu+mria| . -.-_x'-Depth of fiKnrmm+erioL-------'Totu| length-------------------_------- ........ <br /> Seepag! <br /> � mmoncm ,on <br /> Cesspool: --------Distanc? tion-_/0 <br /> ,PitN be' I ning material. <br /> Dish�nco from'noun6sf ~a|L-.. -........Distance from foundation--------------------Lining material............ �» <br /> [] <br /> Size: Diameter----------------------------�t...�!.Deo+h----------------------------------------------------Liquid Capacity............................gals. <br /> ' - � <br /> Privy: D�fmn�e �nminom,�o w�L'��-'-'''_-'''-''''-'Di�unca from naa"y� buU6�g--'--_---__---'-' `| <br /> [] Oi�ancotonoony� lot line-- ------------------------------------------ ............ <br /> .-.--__.______.__.__._________.. <br /> Remodelingand/or repairing (describe)-------------------------------------- ------------------------------------------------_--__-____----.-_-__--__.-_ <br /> --------`--''--`------''--``-------------'-------------'---'---------'-'`---''''---'--------'' <br /> ���������������� �:-----'����'��' <br /> I hereb c ify th�fl have �.repared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances. to laws, and les and regulations of the San Joa <br /> e quin Local Health District. <br /> my�_ <br /> (Plot pshowing � <br /> " ' <br /> '� ""� °. °" �°�.=" =` ��.�" ~ .=�. <br /> . . . FOR DEPARTMENT USE ONLY . <br /> .^..^-.~ ..--.. ~- ^~ ' ~.`.^.--.__--.__--__--- <br /> BU|LD/NG' PERk4[T | _-'__----'--'---''-''-------__'''---'--- DATE'''-'__.-__''----'-______ <br /> AMermtimnymn6/or ---------------------- --------------------------------------------------------------------------------------------------_ -------------------------------- <br /> --------------------------------------------- <br /> -'-''------'--'--'--'''--'-----'---'--'------'-'-- l <br /> '�l'' -------'--'-------'--'---' ' <br /> '-�p~~~''-~~ ~-~ - '~�°'`---='~�"�~----'------'------'--'---' " <br /> —'--'-----''--'----'_-''----------------------------------- --------------- <br /> ----'_''''----'-''-''_-''-'_-'-''_-,--- <br /> FINAL INSPECTION BY �� Date......../ '���/�� ------------------------------- ' <br /> i�SANJOAQU|NLOCALHEALTHDIST0ICT <br /> 1uwSouth American Street un0West Oak Street 1u«Sycamore Street mosWest 9th Street <br /> + <br /> Stockton,California Lom/'caxfmn/m Manteca,California Tracy,California <br /> = 9 "Cvmo" ~o" "= 5'61 ==" . <br />