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Ar <br /> 0 - <br /> " . " .'e <br /> ., Permit No.-'PATION � R .SANITATION PERMIT <br /> ... <br /> ... ............ (Complefe in Duplicate) Date Issued <br /> Of <br /> ............. ......... <br /> This Permit Expires 1 Year From Date Issued <br /> ....................��:.........L ----------......... - rein esc <br /> dirli-sed. <br /> is hereby made to the San Joaquin Local Health District for a permit to construct and install the work he <br /> jcoZliani ifh Court OrdinAL5 No. 549. <br /> ApplicationThis application is m in <br /> ............. <br /> ............ . .... ." <br /> JOB ADDRESS ANMC mo .......4. -1---- -------- --J-- - . .. ----- -----....................... Phone................................... <br /> Owner's.Name........... ........... . .. ... d ................. <br /> .1, A .......................... <br /> ,2? ... ...... ............................ <br /> Address_ .............../. ........... <br /> .......... . .... .. ..... ... ........................... Phone................................. <br /> .... .................................. <br /> Contractor's Name-------:-------------------- -rfm* t""Hous-0 (3 Commercial [] Trailer court 0 Motel 0 Other 0 <br /> 'installation will serve: Residence ❑ pa an c2 Number of baths -./Lot size ------ -- ------........ ...... ..................... <br /> Number of bedrooms -- <br /> Number of,living units* --/.. va to �'�D.pth to Water Table ft. <br /> Water Supply: Public system 0 Community system 0 <br /> Private ay rol Adobe ardpan 0 <br /> Character of soil to a depth of 3 feet: Sand El Gravel [3 Sandy Loam [I Clay Loam 0 CI <br /> I No B�-rHA/VA: Yes ❑ NoO r <br /> Uprevious Application Made: (if yes,date._.-._............) No M��Nevr Construction: Yes 0 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS:i r or is avail <br /> (No septic tank or cesspool permitted if public saw 11111blis Within 20()feet') ................................ <br /> I o <br /> from foundation Material.... <br /> P. t ic n Distance from nearest well-----------------Distance Size-----------------------------Liquid depth,........................Capacity---------------------- <br /> No. of compartments-'-------- ---------- <br /> ................ <br /> os nearest well................Distanre from foundation--------------------Distance to nearest lot line <br /> _..:__..::-•:•:.os Distance from n of each line-----------------------------Width of trench................................... <br /> Number of lines-----------------------------------Length Depth of filter material......_....-... Total length--------- ---------------------- I <br /> Type of filter materiaL....................y-.-Depth 1 <br /> P. t 11 1P0 Distant m foundation. ._ <br /> ......... _.3..------- <br /> iistanS�to nearest lot line. <br /> Distance to neares vp ... - - i *?..9.................. <br /> �:i -1 n-.g----material. . . <br /> meter.. Q-- ---Depth--- <br /> Seepagsp Number of pits...... a Dia - ------ <br /> 30� /-------------- <br /> cesspool. Distance from nearest well.................Distance from foundation...................Lining material-................................... <br /> 0 Size: Diameter------ ------------------------------Depth----------------------------------------------------Liquid Capacity----------------------------96's- <br /> Distance from nearest building...........------------------------------ <br /> Privy: Distance from nearest well------------------------------------------------ .......................... ...... <br /> 0 Distance to nearest lot line..................................................................................... <br /> ............................. .......... . <br /> . <br /> . <br /> ........ <br /> Remodeling and/or repairing (describe):_.....................---------------------------------- -----••--....__.........._... <br /> .......... .... <br /> ............................................................ <br /> .......................................................................................... ..................................................................................... <br /> ................ ............................ <br /> ..........................n----------------............................ ........................................................... <br /> I hereby co r ............................... ......-------d that..f It.e-work. ..will..b.a.done in accordance With San Joaquin County <br /> .�Ify that I have prepared this applicati6n an <br /> a r d i,n-a---n-ie-s-t...if-....e-i---�-,s-,-a-n--d----rules-...-and regulations of the San Joaquin Local Health District. <br /> W, , - I , - ner.and/or tract <br /> (Signed)....... .. .......... I-------------........... ................. <br /> By:.------------- ----------- --- ildings. etc.. can be placed on reverse eldsl- <br /> lot, location - <br /> 9 sin of f:�As am it. relation <br /> (Plot plan. showing ion of`Sys" in <br /> FORDEPARTMENT USE ONLY <br /> ....................—-------------------- ----------- DATE.......------------ ................... .......... <br /> APPLICATION ACCEPTED BY-/V--- —,................... ............. <br /> ------------- <br /> -- DATE..-REVIEWED BY...................----------------- a------ ........._..............I......7 --- DATE---------------------------------------11................... <br /> BUILDING PERMIT ISSUED......... ........:�.......----------------------------................... . .......... .................. <br /> I . . —.1f i fes-4.1........................_.- <br /> d <br /> ................. ...... ., <br /> Alterations and/or recommorldleflans:-...... ------ ........................................................... <br /> ............................­-.... -........--...............................--..... 1. ....*------ <br /> .•.._---.._.........;..........--.......................... .......----....................... ........ ............f------------------------------------------- --- ----- <br /> . *... I ............--!�...............--...................................................................................................................... <br /> .......... ....................I............... ................-------------------I...............................-.............................................— <br /> ....................................................±=.......... .......... <br /> FINAL INSPECTION BY:XTI... ------------------------- - Date...... ................................ <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 300 West Oak Syreel 124 SYCOMOM S11901 205 West 9th Street <br /> 130 S,,Ih American Street Lodi,California Manteca,California Tracy,California <br /> Stockton,California <br /> 9 FIEVISED 9-59 2M 5-61 AILAS <br />