Laserfiche WebLink
ArUKUrrlt_t : <br /> -�-- ----- -_ z �-----_-.- APPLICATION FOR SANITATION PERMIT Permit No. ..j... <br /> ----- ----• --------------------------- ------------ (Complete in Duplicatel <br /> ---------------- This Permit" Expires 1 Year From Date Issued Date Issued 7--21___ <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549, <br /> JOB ADDRESS AND LOC TI N_.. .L -------- '3 A,. e` o_1.4 _�`' ------•------------------------------ <br /> Owner's Name---•--------- Qj� . I�� -f__-••--------•---••- -------------------------------------------- Phone---------------------------------- <br /> Address--------------Orr— `__ <br /> Contractor's Name--.------•---, Q. <br /> ---•-----------• --------------------------------------------------- phone................................... <br /> Installation will serve: Residence WE'Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel [3 Other ❑ <br /> Number of living units: _/--- Number of bedrooms-.- Number of baths-A.. Lot size- Ef cam__"._..__ <br /> • <br /> Water Supply: Public system E] Community system ❑ Private [F'Depth to Water Table -f�ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay p Adobe Or---Hardpan ❑ <br /> Previous Application Made: (If yes,date--------------------) No P' New Constructio: Yes 9?"'1\lo ❑ FHA/VA: Yes fgo'No ❑ <br /> .. . <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> r , J -� z <br /> Septic Tank: Distance from nearest wev�ll -------Distance�fr�oym foundation___/R_---------Material---_ <br /> No. of-compartments---1*1--------------_Size? ---X_!�'Z_F.Liquid de fhr-_ <br /> Disposal Field: ` Distance from nearest well -f Distance from foundation...l <br />