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FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PEkj,,IT Permit No. <br /> ---- <br />( - Date Issued__�his Permit Expires I Year From bate Issued <br /> ein <br /> Application is here4y made to the Son Joaquin Local Health District for a per'mit to co6struct and install the work her <br /> clescribed-This apprication is made in compliance with Count� Ordinance No. 549 ancl�existing Rules and Regulations: <br /> Owner's me z- <br /> ------------------ <br /> --------------- <br /> Number <br /> Wates"�p --------------------------------- <br /> ) <br /> 11' f-E�iltoaclept f f�eet- Son Sandy Loom Clay Loom 0 <br /> (Plot plan,.*khowing size lop, 4oc i 5, f stem in rel.6tion to wells, buildings, etc. must be� ' pldi ed on reverse side.) <br /> NI 7( feet,) <br /> NEW INSTA' LLATION- Septic t nk o seepage pit pd'rmitted if public sewer is available with <br /> ` ' '`^'-- - ' —x <br /> � muu"ov <br /> es <br /> Typ Material "%A <br /> . � <br /> `. <br /> ` <br /> -------------------- ---------------------------------------------------------------------------------------------------- <br /> ------------- -------------------- <br /> ----------------------- -- ------------------------ ----------------------- <br /> sm ---------------------------------------------------------------------------------------------------- <br /> %M� (Draw existing and required addition on reverse side) <br /> '1A ccordance w4h,San Joaquin <br /> - <br /> `�oun'tyVrclinances, Stote Law'_s�, n Rules and Regulations of the San Joaquin Local Health District. Horne 6wneir or licen- <br /> ts signature cerfifies�the following: <br /> en <br /> e that in the performonce of the work for whl�,thii Airmit.,is issued, t employ,�any person i ni such manner <br /> rt f <br /> ------------------------------- <br /> (if other than owner) <br /> FOR DEPARYMENT USE ONLY <br /> ' e rip* ertify that I have��p p this application and that the work will be done in a ' <br /> ADDITk3NAL COMMENTS --_--'--_'_----'-_.-- <br /> —__..—�H-----D-_�T—K|—CT_-'_---'—'--^—''-- <br /> ''--'�. <br /> —_—'—'—_----'--__----_—'-'_----_--'---_—._''—_—'-------'-'—'--------' <br /> —_—_—''—_—_--'—_'---_—'—_--�------------ .---__---'_—.__—_'_ <br /> — �'—'^--' <br /> ._______________ _ _.___ �1IL/ <br /> ---,'[ate --,.�' -7�—�-----''Fino| Inspectionby: _----------------------------------------------------------------- .. <br /> SAN ` N {CAL HEA <br />