Laserfiche WebLink
FOR OFFICE USE: <br /> FOR SANITATIbN PERM' IT <br /> (Complete in Permit No. _7�.........''� � <br /> � /~ - <br /> T�� ���i �www� .�_/�/�� <br /> k <br /> Application is hereby made to the Son Joaquin Local Health District for p � � ^ �� <br /> work herein <br /> nexcnowu. 'mn app|�mfk*n is.nadmin uonn�kono» *��M �*6| ,-'' --�^~~ install" ° "=m <br /> .� ��wnmy non�� Mu^ 549 and �xfwf|m� 0w|�m and Regulations, <br /> [ <br /> ' "R DEPARTMENT USE ONLY <br /> .___ � <br /> LOC <br /> Owner's Name <br /> Iristallat ion will serve: Residence[]Apartment Houseo Commercial oTraller Court 0 <br /> Number of living units:....V.... Number of bedrooms ...Garbage Grinder ........__ Lot Size <br /> Character of wil to a depth of 3 feet: . Sandp --Silt 0 'Clay 0 Peat C:1 Sandy Loam�jj Clay Loom 0 <br /> (Plot plan, showing size of lot, location of system In relation-,to wells, buildings, etc, must be placed on reverse side.) <br /> NEW INSTALLATION: JNo septic tank or seepage pitpermitted if public sewer is available within 200 feetJ <br /> PACKAGE TREATMENT f J SEPTIC TANK f Size.........$7,x... X /0 <br /> Capacity J-400_--- Type <br /> SEEPAGE Distance to nearest. Wet! _­,;:�Z_ ........­.. Foundation Line _45 <br /> I hereby certify that I have prepared this application and that the work will be done In accordance with Sort Joaquin <br /> County Ordinances, State Laws, and Rules and Regulations of the Son Joaquin Local HealtK.District. Home owner or licen- <br /> sed agents signature certifies the following.- <br /> "I certify that in the Oerformance of the work for which this permit is issued, I shall not employ any person In such manner <br /> as to become subject to Workman's Compensation laws of California." <br /> ` <br /> ' <br /> --APPLICATION A-[-[-EP�T�ED, Bf .,'�-r�' .. =_'-----------''~---~`~ � - ---`-'-~`---^~--- ' " '~'—^---8U|LD|NG" PERMIT ISSUED <br /> ------ <br /> ----------- <br /> ---------------------- <br /> ---------------------------------------------------------------- <br /> DATE --------ADDDlONAL COMMENTS <br /> ---' - . -^-^--~-'. <br /> --------- ------------- <br /> __--------' <br /> -------- ----'_-----------------------------' <br /> Final Inspection . -'--'--------—-- ------ ------' <br /> ----------`-----_^-Date .4«s- r75------- <br /> ' <br /> �8 13 2b I_68 ~~"° -514 SAN jO\QUIN LOCAL D���Q�T R/r� <br /> n^=`'n ^° ,w 3M <br />