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| - -------�v�-�) Permit Np <br /> �y z/ ��P���T���� ��� ��������� ����� ' <br /> in ONpUcmfel Dote Issued <br /> --- This Permit Exeires 1 Year From Date Issued <br /> J |nU t � h �A6�kco on is hereby mud�to the 3oo Joaquin Local Health D|,f,icf�n o permit to construct an �uh � d. <br /> This <br /> applicationis d in compliancewith County Ordinance No. 549 <br /> � �^ <br /> ROB ADDRESS AND LOCATION... ' <br /> ------------------------------------------------------------------------------------------------- <br /> [-Contractor's Name-----ln�� 131 7 3 --------­------------------ ....... Phone......... ---------_--_ <br /> Inst allationvill serve: Residence E] Apartment House [:] Commercial C] Trailer Court E5-"Mofel <br /> El I Other CI� <br />. ' <br /> Number of livunits: -� Number of bedrooms ---�. Numberofbaths -� Lot size ��� � <br /> n �Water Supply. Public system mmu^ifv system [] Private [] Depth toWater Table 6m ft <br />� Character of soil to a depth of 3 feet: Sand [] Gravel Sandy Loam Clay Loam [ Clay [] Adobe nJpmo' ] <br /> ;Previous Application Made: (if yes,date...... -------------) NoN�* Construction: Yes g-~I�o [] FHA/VA' Yeo [] No 2�- <br /> � <br /> TYPE OFINSTALLATION AND SPECIFICATIONS: <br /> `�No septic tank or cesspool permitted if pwbric*ewmr is m°mila6\w within 200 feet.) <br /> �^ <br /> Septic Tank- Distance from nearest Distance from fn 1-0L <br /> No. of comportmonto-'--'177�..--.bizo---- Liquid dop7h'/e---_----Capacity ^�=� ` <br /> ` nis | o|6� Distance from nearest woAnew-�.-_Distance 6nnmfoun�aHon'��'.-----D|�mncetonaa�o lot |ine.�1-'-'-'.- <br />' K� � �' Nvm6�, |ln LongH` o9eux� |in=...—��g�.----��YV|6t� nf �non6`----��- <br /> �—...�'_- <br />� ~~ TvPa of filter m*+ado -.-Dootk of filter mutnriui-.Ar----------- length................. <br /> ---------.......... <br /> ���p��� Ht Distance +o oo*m,twwii-.-_--_--0io+once from 6zun�ut�on'-----'__-D�+uo�wtu nearest �� Uo�...-'---'_ v <br /> U � [] N�m6e, ofp��'-_-_--_.Un�ng mu+e�aL___----.S��� D�mater_--'-.--.--D�ot�--'_'-_-_-'.'-- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation-_--'---_Lining mof*,iaL--.-''-'-'- -------- ' <br />� <br /> D� u�6 CmnucHv. �� [] S6a� Diameter------------ F�o..-_---_---.----.---'---'-.L�. Capacity--'--_'_-''-'-�.' /\ <br /> Privy: Distance from nearest well--------------------------'.--------.Distunco from nearest building � � �_�__�_` <br /> ---Q|�unso~h�,`wura�-���� --� -------------- _--_--____-_-'-_-- <br /> k <br /> / <br /> �+ Kmmo6efing and/or repairing (describe):------------------------......................................................................___. <br /> ,'-_'--_-__--'-..''_-_-'__--'�----'^-'_'_..---_---'---.'..------_------_---_--_---_--.'-'.---'_---__--_-'-- <br /> ----'' <br /> I hereby certify that I have prej�&ed this application and that the work will be done in accordance with San Joaquin County <br /> ordintrices, State laws, and rules and regulations th San Joaquin Local Health District. <br /> v i relation to wells, buildings, efc.. can be placed on reverse side). <br /> � . `` plan. <br /> �� FOR DEPARTMENT USE ONLY <br /> ` �a-PPL|CAT| . � '--'---------------------------- <br /> .^..,-. <br /> REVIEWEDBY-_.-__-___-___~___ _______..__._____ . DAJE_____._______________. <br /> IT |5SUEO...------._---.___-_____._-_________.__________..__ DATE....... -----------------------__.______BLULDINGPERM <br /> ' Alterations and/orrecommendations:-------------------------------------------------------------------------------------------------------------------------------------........................ <br /> U ' -�--'�---------'''------------'''-----'---''''--'-----'-''---------------''''-----'-'-----'---'-------- <br /> . . __.___-____------_----.--_----'__---_.--_----'-..---_-.'_�. <br /> ���.'�����������������'����������� <br /> _�_--_.-_---''_--___-----_-_-'_--.-.--_._.-..----_---...-------.....--_-----.-.-.-------^.-^.--'^.- <br /> Fi _--_----_'-_--------'--------------------------'------''------'--'----------' <br /> ' <br /> FINAL INSPECTION 8Y:-.*�-1�. Dota-- .--_.-__------ <br /> SAN JOAQUih(LOCAL HEALTH DISTRICT <br /> 1,30 South American Street 300 West Oak Ure° 1u4Sycamore Street 2mwWest 9th Streit ' <br /> Stockton,California Lodi,California m*"�=,.mmxmm/a n=mc�w"�� ' ) <br /> / <br /> c� Expstev^,mo*rw^ o,wATLAS <br /> ' <br />