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APPLICATION F.Qfk, TLA710N PERMIT74
<br /> (CompfatS,,Wln1j> reale). Date Issued .................. V
<br /> This Permit Etpnbjs TH' Frofar Date Issued
<br /> ry
<br /> \ y.: , hemel•y nla,le, to the San Joaquin Local Hea!!y4t �Jsfllc n^omit to construct and insMll Me work herein described.
<br /> made in c ompliarce�with County Ornd�na �d rs$'4`>'-./•�/.
<br /> • G'.�L'G /IL L rJ 1 / _ • . .................. V
<br /> Of
<br /> 1l`l`KI SS .IND LOCATION.. < `w(a'{/,L......iQ-,........
<br /> 2 i /'61FSf . ..... .......�- .......... Phone................................
<br /> .�tf ,/c �..s. � '`. ............... Phew................_......_._...._
<br /> �'.+trnapr's
<br /> Name. j/a(T"L� itaf-4..'[7 � `� . ......I................:..
<br /> Installation will e: Residence ER"'Apo' House 11 ,�!^�n••gm
<br /> al Trlar Court ❑ Motel 13 Other ❑
<br /> san
<br /> ,!- ...tiiirtiA±' �Lf'beths ...�. Lot size ".,k..-��'-_��.................._.......
<br /> Number of livingands: . Number of bedrooms N " Vit,
<br /> Water Supply: Public system ❑ Community system ❑ ':;Y 'f 'repth to Water Table *1". ,-eVms
<br /> Character of sell to a depth of 3 feet: $end❑ Greve! ��..y`.x',+.{ndl's„Stu'grh❑ Clay Loam y
<br /> ❑ Clay❑ Adobe „ardpen 13
<br /> Previous Application Made: (if yes,date_ - 1 No iT 4rit'. Fnstruction: Yes FHA/VA:Yes[n/NO 0
<br /> TYPE OF INSTALLATION AND SPECIFICATIONS:
<br /> (No septic tank or cesspool permiHed if public sewe- t vl�rMrbls� +ffiin 200 feaf) r /�•• /�1s�� •�� ���((
<br /> D;;t ^ -!;.undalion. .��......Meter el_lt.w.v..r6A/'�Gsr -••--•••^ `
<br /> Septic Tank: Distance from nearest weIL L' r, Li uid de th.....y ee . Capacity. . Jr0..Q.-••• `
<br /> QI•/ No. of compartmenfs....�. .. ut:^ •+� 4/C-' q p $ .. --.-
<br /> Disposal Field: Distance from nearest well�.w i Uls ap+s.\Y r': undehpon �C ...Durance to nearest lot line..trS..-....-..
<br /> Q� Number of lines .or L•L«r^4 fd"•qtr I' I, a_ y! .Width of trench..
<br /> O.'. .,9-�....................
<br /> Type of filter material/�i-Ad /� q •', '{materml �T�. ....total length ...�.�.0................_........
<br /> YP .�. ll l.er sn9
<br /> ' E.. .Distance to nearest lot Distance to nearest well �.J l.• Dls,wt<irr�rN'�Sovndezo: ,?r�. ._ Depth.-.p.�0...............
<br /> Number of pits .L.. .. L nineSixes Diemeor ... ---• 4
<br /> Cesspool:
<br /> Distance from nearest well. P`, ,--]c i a:n 4.�.,ndation. . . ......_Lining material......................._........ d
<br /> P°O' , ., .x .'w. .�:, ._....-...-_Liquid Capacity. ....................gals.
<br /> Size: Diameter... ._ ._ .rr
<br /> Distance from nearest building. _.. . .... .
<br /> Privy: Distance from nearest well ]re
<br /> Distance to nearest lot ;;ne "-• "' -- ..
<br /> �(Ct
<br /> y_��,L -.. ...-.. ...
<br /> Remodeling and/or repairing (deseriboJ: ,r, .•"_ _
<br /> -... .. .... . s
<br /> p
<br /> .,( 4 ....... ...
<br /> I herebyY certify that I hove prepared this applicahori}.•?n.. � bc
<br /> '.gwork wilt be done in nccordenee with San Jwqur Ceunly
<br /> ordinances, Late laws, and rules and regulations/of the Sea +MtraI Health District.
<br /> (A—savor Contractor)
<br /> IS;gned). #�7 � _ .�j /�'.,(•L
<br /> i
<br /> B
<br /> y
<br /> IPlot plan, showing Size of lot, location of system rp�er�n':'rs s�+,iw;"+!dm9s a}c•, can be placed on reverse ddo)_--�
<br /> OR DE- "T'".ONLY
<br /> `{ ' s 'S- _ _ _._ DATE.. s.w... � J...lir,
<br /> APPLICATION ACCEPTED BY.. . ..• + vt DATE. -
<br /> REVIEWED By . . DATE. . . .. ... ... . _ -
<br /> BUILDING PERMIT ISSUED _ •+
<br /> Alterations end/or recommendations; i....-/ '< .r •' - _. _. .
<br /> it
<br /> :h. Dale ..� .. . ..... ._ ,
<br /> FINAL INSPECTIOtI BY:-1 : . . - +
<br /> SAN JOAOU�"-''.I: s'+1, 'i°..rH DISTRICT
<br /> e
<br /> ]00 w O . 5 q ><Svnen Neer ]Of Wo.911,S"..'Srn
<br /> 130 South b•,nlmn SP'--' m- eY i. t', e.Caeb.nle r.ary Coulemia eF
<br /> l,esnen Cnne•nIe sea,cc-I-'-
<br /> ad ""•' zl.
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<br /> sL _moi:
<br /> �vz =�• .- r—a'.�Ipeelw - - -S.
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