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\ <br /> ^ <br /> APPLICATION FOR SANITATION PERM[[ Permit No. <br /> _J <br /> (Complete in ~~�^~~^=v <br /> Date /ssuo6 <br /> �-�Application is hereby made to the San Joaquin Local Hnoith District for o permit to construct and ln��U the herein described. \ <br /> This application i� made |n compliance �if� County (}r6ynon�n No. 54Y - ' <br /> ^-� ( <br /> ` <br /> Address <br /> -------------- <br /> |nst*UuHom will oen~m: Residence Apartment House [] Commercial [] Trailer Court E] Wnta| [] Other [� ' <br /> Number ofliving units: -------- Number vfbedrooms ;?- Number cfbaths -I-' Lot size <br /> Water Supply:Supply: P"6{ic ,y,+om A Community system E] Private El Depth to Water Table -------- ft. � <br /> Character mfsoil +pmdepth of3feet: Sun6N Gravel F] Sandy Loam [] Clay Loam [l Clay El Adobe[] Hardpan E] K� <br /> Previous Application Mede: Ye, E] No < No. Construction: Yes W No [] �p <br /> TYPE OF INSTALLATION AND SPEC|F|CAT|C>NS, <br /> (Nm map+|c tank o, cesspool permitted if pv6|i seyer is U 6| within 200 feet.) <br /> Septi ank: i.n <br /> DisposalField: �� �3 <br /> on- -Distance to nearest lot ir,e___ <br /> ---------------------- <br /> Senpuge Pit: Distance <br /> [] Number of ' <br /> --------------------------------- <br /> Cesspool- Distance from nearest well-----------------Distance from foundation--------------------Lining <br /> r � [] Size: Diu '- <br /> -- P,�v Distance <br /> from nan,e, �eU--��_�-'.-'''---''-_--Distance from nearest 6u||d�g - -'_-- <br /> �] Distance +� nearest |c� |in�-------------_'-.-_---��----------.�__._.____-_�..'______.. \ . <br /> Remodelingand/or repairing (Jemcri6u):--------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> -------------------------'-------------------'------------'-------''--'--'-----'-'------'-----'-- <br /> ------_-__-''--__.'''___'---'--_-.-__-'-___---_____.-__--__-_--'_.--..___--__---__-- <br /> ______'_______�____________________________'___________'________--4_____________'____'_______'___ <br /> hereby certify that I have prepared this pplicafion and that the work will be done in accordance with San Joaquin County <br /> ordinances. State I S, and rules a d gulafi s of the San Joaquin Local Health District. <br /> (Plot plan, showing size of lot, location of system in relation to Wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY------ <br /> BUILDING PERMIT ISSUED------------ <br /> T T <br /> SAN JOAQUIN LOCAL HEALTH DIS e <br /> /au South American Street 300vest4 Oakstr6f /sm Sycamore Streeow m"*h "C" Street <br /> Stockton, California L^di. Ca|a"mia Manteca, California rm"v. California <br /> ES-9-2M n'o/ xev�,^J W-//oo <br />