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FOR OFFICE U5L-. <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> ------- This Permit Expires I Year From Date Issued <br /> G*Cand install the work herein described. <br /> Applicfifion�is hereby-made to the San Joaquin Local,Heal.&Districf for.a permit-io-constru. <br /> This application 'is made4 ini-corripliancewl+h County Ordinance No. 54 <br /> i . — P �Z ,'. ------- (� ......................................... <br /> Intfallaflon will'serve: Residence a--oApari-ment House D Commercial [3 Trailer Court10 Motel 0 Other 0 <br /> Number of living 'Units:.-'-/.. Number of 6edrooms-3--- Number of baths _Z. Lot size -------> . ----Z <br /> Water Sup�ly: Public system. PEr""Community system El Private E] Depth to Water Table <br /> .1 Clay 0 Adobe Erl,`Hardpan <br /> Character of soil to a delpth of 3 feet: Sand E] Gravel 0 Sandy Loam El Clay Loam E] <br /> No El <br /> Previous Application Ma�e: (if yes,clote-------------------- No [:3 New Construction: Yes E] No Ujo;;FHA/VA: Yes E] <br /> TYK OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permiffediLtublic sewer is available within 200 feet.),t <br /> e. <br /> Disposal ��cl: Distance from neares well.)�W----Distance from foundation ----...Distance to neares :x <br /> 13 IF f <br /> Privy- D.ist ce from nearest well------ --------------Distance from n <br /> I hereby ce0"hat I have prepared this application and that the work will be don? in accordance with San Joaquin County <br /> ordinances, St rel s, and rule nd regula o s of the San Joaquin Local H 4 ealth Disf6cf. <br /> --------------- - --- --------------- --- -----------------&__0,1wner and/or Contractor) <br /> By:-------------------------------------------------------- ------------ ------ - <br /> ot I i . etc., car be placed on reverse side). <br /> (Plot plan. showing size of lot, location of system in relafion io wells, �buildi <br /> FOR DE ARTMENT USE ONLY <br /> DATE <br /> | ---------- <br /> Alterationsmnd/mrrecommendations:-----------------------------------------------__-'—'--__''------'-_-------_'—'-_''-- <br /> . .--_---_-_—__--._---___---.---.—.__-'__--_---__--_-'--__.----___-------_-_.--. <br /> ------``-------`--------``---`--------`­-`^`-----``-----``---``---- --------```---``-------` ------------------------------------- ------------------------------------------------------------------- <br /> ---- ---------'--'------^--------'----`------'-----'--''--''-----'-----'--` <br /> / '--'-'''--''—'--'''---''-''---'-'--' <br /> -''--------'-'--- <br /> �-- � � - � �� <br /> F|N/\L INSPECTION ��� x�L°��x�^-~"°.^. Dut�---'�/--'==.'_-.~^..__~-------'-- <br /> | '^ <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> o��m���� �x^��m�v� o����o� <br /> � mo�**,��w,/"w"�=° . _ <br /> . Stockton,California Lodi,California m=mca.California 7racy,enornia <br /> ES , "P°"V" ='°~ u" "'°' ^``^° <br /> '~ <br />