|
' .A� �,t G rtxa' E .•�,+r���+r�esM1,t �fi�'S°���' � 'F { " � '�
<br /> � °+, .>r���trr � � .�;,, .Vii',+; _hr: �•�f ,5 ��'',�' ���t,a;� t ' q y.
<br /> r
<br /> ,v A `_ i
<br /> APPLAbAmON FOR PERMIT
<br /> SAN,IOAQUiNlOCAL HEALTH DI$' ICT
<br /> IODI,C'HAZELTON AVE:,'
<br /> PERMIT EXPIRES 1 YEAR FROM DATE iSdUEO
<br /> r. +}ate in T I-;='� ''" �,l'll
<br /> ' F'� .''r` t;"�•', .�' ':'�,•b'(CAW
<br /> AptNoefion Is hereby nerds to the San Joaquin Local HOBO OMitrlet for a WH*to oorletniet OW/or>rtatalt this mak lis[dn:4�ael�ad. apOMl+1Me>N�
<br /> sntldw io..-Corr+oMar+cs vm Sen Joaquin Old ccs No IFAS for swop or No.Im for tiretilpttetlP ted rtes Rtia and Iliptlsftottetd 1fN SanyJaagdl
<br /> LOCM FlwVtlt Dlsilct.
<br /> t.J&Adl.a /// 19 4
<br /> 1
<br /> ��
<br /> t�
<br /> Address Lkaesa Mo:. © �
<br /> ^ 1 c STYPE Of MVEL1aPt1MP: NEW MYEI.I .0r ''. i WELL NEPRJICENIENT 0 +' ,' •'s T g,'
<br /> P[1MP INS7AW4E
<br /> SYSTEM REPAIR O G +f'vON ❑ � C
<br /> v �$PQ$A!;�t.p PRA7P I Mfg
<br />' ;��M ANC$ 3'O NIANEST: SWMTANK —'s� LINES
<br />{ � � FOUNDATiON A&M-.ULTURE WELL OTMER WEii. Pt:81SUMP8 . b .4 `
<br /> � OF VVEU: PROBLEM ' CMSTRUCTWN SPECIFICATIONS "^
<br /> 1 ENbED UiE TYF' �'�= `
<br /> �i'e' M ��drnir11c1Prlwte tlattCttt.. Heirlam.
<br /> f' Oir of WN Eaea+oOdonO iduoumk fl Open
<br /> , , Type of.44 ❑Graeat1 �haty dYMif CYsk�Y r'
<br /> � � + ❑Osiris Depth of G"A SeM 'fes d awl ,
<br /> �. r
<br /> Vi
<br /> �' ;' ? , --APP .Depth ❑Fsstsm' Surface SMI uratatiid Wb�c Oona:,
<br /> i VVbek OonE G Type of PUrnp: H.P." I _ yy
<br /> 1` OM1i'i d� Sednp HMwiM Itop rte{
<br /> •
<br /> p �a$4rvr, l: Fier Illhtellal
<br /> fEe1bM1
<br /> PE SEPTIC WORK: NEW INSTALLATION REPAIR/ADDnmN DESTRUCTION r�� Ili s�� n fast.)j ��s�w N
<br /> {,Y fttAtlpMlber'uA airve: Rseidenes ConrrresrdM��
<br /> * �lun►6llr of AiinQ uMts: Nurn6rt of >s WWr tt tlrpdt _
<br /> err tnt.bf W to a deed+Of 3 icer: t F b
<br /> ti$EtIC�rtANK.'•i,M * G!' Type/t�Afa y l No.Ootntiaia 4
<br /> �+ tttethod of Mi
<br /> Uffip
<br /> >SICO.'TR ►THENT
<br /> T.❑ �
<br /> W'," Weq�r►� Feardetion P*04 Lllla
<br /> 1
<br /> EACH1Nti LINE L�No.A Letrpdi d Ansa y; rY* le ,� fi tad ,x
<br /> ' " 1 0 Durance to nataasu IIW1 Jam— Fauna tloa.�..�
<br /> 1,4L la `pc I=R:S'Ei�BEO'A " .w s a;, ',f r a y,#'i'F F .., r irfi'L«:.' Y a c
<br /> 3 x a'`t' �_••:. x.A,1 ..,=r x>'wt I
<br /> EkPAGE$lTS 0/�fi
<br /> : -lir Q�itallOa tCrMa1Mt:-t, �IeE.. Q 11
<br /> •� .y
<br /> *vM be de ti sr�asdmi0a wide San Joaquin+tSouhly ar/irtees,etas l{ma.sand
<br /> l��� .�1 irseeby awtVv tlrae I halve t>t��thi<sp'P sad slat this vmon
<br /> 111Iae and trpitgtions of tis San -Loaf Heahh Dltlrlct. 3
<br /> Hens►ra Owerr Neerwd sperrCs stpnatlne deAlllss tis[adhwMtp "I osMy Mat In tlra pulCtttranea d eha'melk fe►eltlrkit tits pirt111t is Iaten4 I alerR erI[
<br /> Vii;? t irtrldy irtY oteaari In such manner w 10 beonrne vib)af:t to riprkenan's aerrrperreatlen tariw d L'atllateta. a Nl4t f}Or�p
<br /> ijbareNlsa the fOMOVflrrp "!tlsrdfy that iA elle petfarrnanot atM 11rOrk ftX M111Cl1 dela pMenk Mi lwinq,!strap ateyrltfy p,yirMir itebNet 1e►wetkuirWa aa{ap�tta},
<br /> J PIWAa"
<br /> C fdt lama d CI
<br /> dew Ing an f Woo
<br /> t'� -- FM�pp�eNlt,llatet W for rlpec$atrrt:Car�l{l!
<br /> �1 t �''i,. '� .__J. W� .tl F t�S 3+�" 4 :';�„a "`+�ar.'��,- •�°k . .>
<br /> OWAtffnm"r UtiS
<br /> `r� hP1[or'Qlout ReMpsodott by Date Awl MnOaetetigi
<br /> i r. .. A
<br /> 11
<br /> �°y� A�IId1MI Qa1rMeNtrta: �' t1A•Illsaa�tt'�7104 T� i-�°��'�%� ��¢��� �'"Ir'a{ - '
<br /> GApprR Mian M copies to:EnrMenrfiwlRa�I�eMlh�iNetMeM fat is ilA.,tJIMt SSSCA♦ 1 Ems`
<br /> k t���'� �,,r�f�•�' �. �. A�. 6� 'p �s � '¢ _�:t l.� �'.y�z ;:5�.� �3"M1"�`r �y. y:ya ��"' �•h..- � -
<br /> �,C� e _4,}-��t�l .. -'Y� qtr ,..,�; �} ,.'="'" �'P-'"per '�°l���i`�y' �.f�11♦��:� ,�.
<br /> A IN a11111eV
<br />
|