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APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) Date Issued ---- <br /> Applica-�ion is hereby made to the San Joaquin Local Health Dist ricf f or a permit f o construct and insf all the work herein described. <br /> This application is made in compliance with County rdinance No. 549 <br /> ----------------------------------------------- <br /> Installation will serve: Residence Apartment House El Commercial 6__Pra�- ourt C] Motel Ej 0�her F] <br /> Water Supply: Public system 6--c—ommunity system El 'Private E] Depth to Water Table Tel ft. <br /> Character of soil to a de�fh of 3 feet: Sand Vl__Gw-a��rncly Loam 0 Clay Loam [I Clay L] Adobe Hardpan <br /> Previous Application Made: Yes [] No 4�ew Construction: Yes 0 No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> ---[No septic tank-or-cesspool-permitted 4-public,sewerjs-availa6le within-200,feet.), <br /> -Dis sal Fiel Distance from nearest well.. <br /> '4 a 4n <br /> :�D' <br /> IV <br /> Seenage Pit: D�sfance to nearest fc, nclafion__,_�I�>._t.... Distance to nearest lot line--- ----------- <br /> El <br /> Remo6e|ing and/or repairing ):---------------------------------------------------------- - -------------------------------- -------------------------------------------------------- <br /> --------------------------------- .''--'-_'---''-__''_'-'-'-_-''-_-''''-''__.--''-'-'-_-'---'--_---''----_'-''''- �� <br />� ._--'--------._-___--'-__--'__--_----'.--_.__--_-'--__-----.---._---_------ ~~' <br /> ------------------------------------------------------ <br /> I hereby certify <br /> that | have prepared this application and that the work will 6e done in muconJonme with San Joaquin County <br /> ordinances,,,5.fate laws, and rules and regulations of the San Joaquin Local Health District. <br />�°~~� ' — ����,��z��,,.-�����-="-�----'' <br />` By --------- ^�� ==~"°_,_________________,� �_, <br />/ <br /> (Plot plan. showing s�omflot, <br /> ` cationof �sfemYnno|w�onf* w�Uo. �u||6|n9s. e�u. can �eoJo�a6onrev�me66e). <br /> FOR DEPARTMENT USE ONLY <br />' <br /> REVIEWED -ic_� - DATE ���' ' <br />. <br /> BUILDING PERMIT |S3UED-_--------------._-r---------------.. -- _______________. <br />/ <br /> Alterations and/or recommendations:-------- --- ----------....... ----------------------------------------------------------- _�---------------------------------------------- � <br /> ----'----------------------------------'—'-----'------------'-------' <br /> -_------------------------------------------------ - -_______---___---------___--_-----_-- -----------------------------------__------------ <br /> ----------------- --------------------------------------------------- -------------------------------------------- '---''''-'''—---------------------------------- ------------------------------------- <br /> --''-''--'''''--'-''_—''-'''--------'--''''--_'''� ' '-' --'-''--- <br /> i <br /> FINAL INSPECTION BY: ------ <br /> - ---------------------- <br /> �~' ----------- Date --.--/-.c/ ',/-�.-.'-./-.------_- <br /> SAN JOAQW|N LOCAL HEALTH DISTRICT ~ <br /> /on South American Street 30D West Oak Street /oc Sycamore Street m* North "r' Street <br /> Stockton, California Lodi, California Manteca, California Tracy. California <br /> -=p-r-"" ~�"~=°^~W"^, `""^ <br />