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( /�^ <br /> � 1 r <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> ���u�f � ^� <br /> , <br /> (Complete ~~r~~'`, Dufa |ssued^' <br /> � / ' , <br /> Application is he,o6, made to the San Joaquin Local H |f h Dist u ponn� to and |nd�Uthe work herein described. <br /> This application ismade ln compliance with County Ordinance No. 549. <br /> � ^ <br /> JOB ADDRESS AND LOC � <br /> --------- <br /> Contractor's Nnmo----.--- --------------------------------------------------------------- Phone----------------------------------- <br /> Installation will <br /> ----------..|nsta|la+ionwU| serve: Residence �° �pu�montHouoo [� Commercial [� Trailer Court [� h��� F] Other F-1— /�'1 �� � �' <br /> Nun~6o, of |�ing units: �Zrmunify <br /> 6 ofbedrooms '��- Num6vr of baths I-- Lot size _.���^-,`�..��l�--_--------' <br /> \�a�r Supply- Public system systam E] Private E] Depth to VVnfer Tu6|o -------- ft � <br /> Character ofsoil to depth pf3 fwef; Sand E] Gravel [] Sandy Lo Clay Loam E] Clay [] /\do6oF�~7�nr6pon [� <br /> Previous Application k4oJo; Yo, 0 No-��New Conx+ructlon: Yes m=r~No �� ^ FHA/VA. Yes [_1 No D , <br /> TYPE OF INSTALLATION AND SPECIFICATIONS:' <br /> ~ <br /> /No septic tank o,ca,vpoo| po,m|+ho6 if public sewer i, available within 200 <br /> Se nk: Distance from nearest well A0Distance from [u clho /j� / .� <br /> Mt io| <br /> No. ofcompartments--------.� ----------Size----C�'���.����-._-�quid depfh-.��'-----.��oyoci+y-..�0hi---. � <br /> D;se|d: Distance <br /> ----------------- <br /> Number of <br /> lineso� �. Length of each <br /> ^' <br /> m+ �L. ..-D�o+ 6[ G|to, material----- �Typo of filter mi <br /> - Distance 10 w�LJ-��L.—'D|�onoy from foun6o�on'- _'-Di�a � <br /> nuun, |ot |ine.��—_. «�/ <br /> ' - Number ofpH� �� ;L ��ning material '''S�o: D�m x <br /> �8.. - <br /> Deo1h6'��/--�-_'- - <br /> Cesspool: Di5tace from nearest well Distance from foundation_ ���� Lining material . . Ul <br /> El Size: Diameter---------------------- ---------------Depth----------------------------------------------------Liqu�J Capacity-'-'-'�-'--'gals. <br /> Privy: ­i]�s+ ncr from nearest well --------''�-'��'_--k--Oistancefrom nearest building--------------------------- <br /> Distance to <br /> ����-'-Oidancefo nearest |o+ |ine`--^_-..,.—.'�-.��-����� ----------------------- <br /> - <br /> � <br /> � Remode|ing and/or <br /> ' napuiring (6eozibe):--------------------------------------------------------------------------------------------------- --------------------------------------------- �~ <br /> -------------------------------------------------------------------------------------------------------- --------------------- ------------------ ---------------------------------------------- - --------------- , <br /> -------------------------------------------------------:; -.__'.__._-..___''__-.'--'----__-'-'--'--'----^. <br /> ' - <br /> .--_---.---._._--_-__-'----..�__---_�_-__-._____-�_-__.---_-__---__----------------- ^� <br /> I hereby certify that I have prepared this and that the work will be done in accordance with San County ` <br /> ordinances, � <br /> ^ <br /> _____''_--''''+�- ^--------- and/or <br /> �x____.._.________._.`_--_----_..---------_---- -------------------------------------- ------- <br /> plan, showing size of lot, location *fsystem in relation to wells, buU6ings, atm.', can be placed on reverse side). <br /> 1011,9EPARTMENT USE ONLY <br /> APPLICATION ACCEPTED 8Y.- - --------------------------------- DATE-_--��L��� --_.—.—.. <br /> REVIEWED HY'---'-�-�_-�'''.�.-�'_'-'''''-- '-��--'-------_-'''--,'' DATE'''-'--'-_.'--_--''-'---'' <br /> - <br /> BUILDING PERMIT ISSUED-_--_-__--�---�'�-^—'.��--~�._-'_._----------- DATE----------- <br /> onJ/u, recommendations:--------------------------- ^ ` .__. ---._____ <br />� ^�[�'�~ ~--''-----'' <br /> - -. <br /> -----'-'-'---'-=-''--'' ~~-'~-' -''''-'''--'-'--''---''----''---'---'---' <br /> ---'----'----------'----'-''�-�����-�~�---.��-����.�l--��-��---J[-----------------.---_________. <br /> ������������------ �'' �� �'' ' ' _ ���_� � ������-��'��'������������'������� <br /> ~-� ^� <br /> HN/\L INSPECTION 8Y' u*�� <br /> / ' -'�f-- �»*-� �=`�°�-- -7^+-''^'------------------'--'' <br /> SAN JCJAQU|N LOCAL WALTH DISTRICT <br />� /oo s=m American Strom 30D West Oak Street oz Sycamore Street m+ North ^C^ Street <br /> Stockton, California Lod|, California w°nte"o. California .. _ '' Tracy. California <br /> ES-9-2M ' n".is"a )'ur rrzo <br />