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ruk O'"`E ""E. <br /> APPLICATION FO ������ Permit N� <br />---^--��� �— ' Issued <br /> (Complafe in Duplicate) �� -- � �law <br /> lication is <br /> ---� �a6. <br /> Mh District�n u permit +ocono�wc+ and ins�Uthe work hen�nda^c, <br /> hereby h, �6� San � � |n Local Hoa <br /> This application is 6n in compliance with County <br /> On6|nuocn No. 549. <br /> ''---''--'---'----'--' <br /> J<]B ADDRESS AND LDCAT|C}N--_..��g.c..�y^_��an��/^+"a.-..------.-----_---_' <br /> ' PhoneI1_0.�_��=-53- 20-- . <br /> Address-_-� = --- =~------''-- -��-''-'---' <br /> Cnntruotn,', Name Dp-t& ' ..-.J.1g0-------------------------_----- .H�" .~'n <br /> _�69 <br /> - <br /> -.- phonoOther [ <br /> \n�mUm�nnw� mo�e: Residence [3 Apartment House Commercial ] Trailer Court [ � , <br /> Number of living units: _a_ Number ofbedrooms _���Number of baths ..{�.. Lot size ---]-�����. I�D�_-._-- <br /> -to- \�otmr Ta ' ft ' <br /> Water Supply- Public system [0 Community syo��m [] Private rl Depthu/e��-. A <br /> '^ <br /> Character of soil to e depth of feet: Sand [l 'Gravel [] Sandy L� 0 Clay Loam [] Clay E] Adobe K] Hardpan F] <br /> Previous Application Made: (if yes.dote---- ------ -------- No N Ne°, onstru*fimn� Yosf�~ No ] PHA/VA. Yes El. W» % w <br /> 7ypE OF INSTALLATION AND SPECIFICATIONS: . <br /> `N* oopK* tank or cesspool permitted if public sewer isavailable within 300fenf.)' <br /> Septic Tank: Distance from nearest well ' ' Distanco from foundation-------------------- ------ ' n-Ing No of compartments-.-:----------------------size--------------------------------Liquid depth _ <br /> Capacity----------------------- <br /> Disposal <br /> '---_CDspo, | Field: Distance from neuI,ao well------------------Distance from foundation ----Distance to nearest lot line----------------- <br /> I -- <br /> .� <br /> ^Lan �� ofeach line----------------------------- y�6H` cxhancn-------------------------- <br /> Ex <br /> --._.-.- <br /> -x -t Ing Number of |�us ~ of filter mn+aru| 'Tnto. �no+k--------------------------------- <br /> Type <br /> '-'---- <br /> Tvpeoffi�armo+e�ui--�--''''-Dep+ , <br /> ------ <br /> Seepage Pit: Distance to nearest Distance f � to nearest lot r0u" <br /> �---------------- <br /> Cesspool: <br /> " -..Size: ~.-_teir__--_-'__Depth' -'- <br /> 5d ' Number of pits <br /> . + _ =`=,` <br /> �* p»»� Distance from noo� sf xv|L _D�toncof",� foundation-------------------- mutoruL-'''-''-_'---s-. <br /> . - .�qu|6 Copndty-----_--.._gu <br /> 0 S�e� �iomot�r-.� _-----.-Depth--_------_---------. <br /> � ------------------------------------------ <br /> Privy: <br /> `« <br /> ' Di�vno, from nearest ''_---� <br /> ' D��n»v from neu,e� weL.----�.�_-'-'_'-- '_______-_ <br /> | ' ^`/' D�t�ncefonour�t'�fl�e'---.-`-'__-_-'___-___________________._________ _ � <br /> - ` -�K�_ j�� -�����u^ <br /> Remo6�ing and/or repairing (du,cri6r):_.A4J4.1u��-�.».,�*er' .- '�^^�^^^^�.~� __________. <br /> / '-'-`___--____-.--_-__-�._--'-.___--__----_.--____-_-_------.. - --''-'---- <br /> --_-'----.-._--__--_----..���.�_.._-_-�_._.____-_-___._-.-___-----'-� �\ -''--'_-.---- <br /> � ' / -_.-__'-__--_-'__.''--''-----'''__- <br /> � ---'--'-'----------'--------�-''�k��--''i--�--an6 that will be dmna1n accordance with San Joaquin County <br /> ` | f�u+ | �uvn ,e� n`m application ^ <br /> »w'wn���n�v '" 6 |�sr`r-�quku��no n1 the H�u|Hm �l`��wt. ` <br /> ordinances. �?wnp /o*�. an rules *"" , . / <br /> |`� <br /> Delta [ ��ti� T� �oS �%� ���, Z��°_____------___-_._-----.( �� ner ao6/-o-, -C_nnhwctq,) <br /> (Signnd\_..' _ _ � _- � � ' . � <br /> 8v: -------------------------- ' itle' -Boen...Mg% °-sid-e�- ----' <br /> (Plot plan. showing size of lot, location of system in relation to wells, buildings, etc~'w*n6m placed on reverse <br /> FOR DEPARTMENT USE ONLY <br /> \ <br /> \ <br /> / <br /> APPLICATION ACCEPTED 8Y-' .......�� tVOuL-6�----^--------'----------- DATE- ' , <br /> --'--_. D�TE.---'_._-_________ <br /> KEY|EVYB} 8Y-----._-_---._..-.--.'--''--__-'-''''-''--'--- ______.___'______________ <br /> BUILDING PERMIT !SSUED---_--�_---_--_.''��.-_''-_''_-� __' DATE <br /> ! ----------- <br /> Alterations =no/ --'t��-uu ''. <br /> --''---'---'''--'-''''-''-''''-''''''''-''--'---'''__-''--'---''-_-'--_--_--- '' ---�'-'-'-' <br /> -'_----'''-''-''-_-_----._-----_-_-._--__-.-_--___--------- --------_ <br /> --''---'-----''_-'---'-''�-'''-''-'''-�''--''--_'-_''_'''-'-'-'''''-'-''� � �'-'--''-'''-' <br /> � ----------------------- ------------- <br /> > r�� <br /> FINAL INSPECTION 8Y-...0...fy'P-m�------------------------------------- .� <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT ` <br /> 130 South American Street 300 West Oak Street 124 Sycamore Street 205 west 9th Street <br /> ' <br /> Stockton,California Lodi,California Manteca,Cal p"cy.m"/n"rnia <br /> "P.C13.2" 6.60 <br />