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FCR SAN:7ATICN PERMIT Permit No. .......!/.. <br /> "'Now, fCompiefo In Duplicate) <br /> ;-X." Date Issued <br /> • I Y3ar From D�ite Issued ... j i <br /> :)Iicat on is hereby rnr!G'1! TO the Zan JC.n '_::r: 1j! ct. for ?, <br /> to construct and install the work herein described. <br /> T appi;'cation is M'10c'. In :ompInnr:(- w1i;, '-!tintvo. S49. <br /> JOB ADDRESS <br /> I-A Atu 0, <br /> C ner's Name. <br /> ...... ............ Phone.................................... <br /> Address...................... <br /> ------- ......*-------------------------------- ----- ...........*"**--------------- <br /> itractor's Name .. .. .................... ............ Phone................................... <br /> IrMallation will servo: Ho;;;L- (1 Conrir;iercial 0 Trailer Court [:] Motel ❑ Other [] <br /> Nimber of 1'•,;nj tjr.,;-,: Numb--i Q"' bedrooms tP2 Number of oaths / Lot size ..... ................... <br /> for Supply: PL:�-I' 1(.� Ii <br /> tion De,-.)`l:1 TO Wafer Table ft. <br /> Character of soli to a Jeof.; otout: .1. <br /> I- _ . _j J6fIcjy Loam C] Clay Loam 0 Clay 0 Adobe;g Hardpan ❑ <br /> P vious Application-, Mlane: :If ) No Nevv Corr-,-,ruction: Yes 0 No [0--'FHA/VA: Yes 7. No E] <br /> TrPE OF INSTALLATION AND SPECIFICATIONS; <br /> (No sepfi�; tank or �-vssjjool permitiA i" public sewar is availab!o within 200 feet.) <br />/Z ank: Dis'ancu from foun(�afion ...... ......... Material................. ....................... <br /> . ..... Liquid dep.th .......... ............. Capacity.......... ............ <br /> -ek.. ...... z, <br /> T Distance to nearest lot line. <br /> -ince from foundation... < <br /> ;I f- <br /> -,�r..:Itn o. each line ... ... ..._......Width of french. .2,'-.`................... <br /> r 1:1'! ref i-11for marcriol ......Total length................... ....... <br /> r !page Pit: -o ricares-, --til! 1&"e' 01;tancd--��, f d ti <br /> a ion—!5/.,.) D I stance to nearest lot line,---'<��......... <br /> Size: Diameter- <br /> i�,c r ;f pit-; L n r; <br /> Depth ................ <br /> Cesspooi: Distance iron; nearr%i voii ..Dis-,once frorn fount ,;fion <br /> C' ...........Lining material..................................... <br /> F-1 J.Zc: D"-arrie�,4r Deo--.h. ... . ... .... <br /> D�S;-:fico train nearest we-ii ...... ...............Liquid Capacity.._.......-------- .........gals. <br /> , Distance from nearest building <br /> ncort,- � I.,: !rif, .......................................... <br /> .............................. ........................................................... <br /> modeling anci/nr 1doscribc-l- <br /> ................ . ............................................................................................ <br /> ............................ .. <br /> .. .. ......... .... . . ........—............. . ................................................ <br /> . .................. .... <br /> ......................... .. . .............................................. <br /> ... . ............ .. .. . .......... ................. ................. ........................ .. <br /> I hereby 5pr*g,fy fhol !.have proparcci iriiis application and that the work will be done in accordance with San icaquin County <br /> ordinanccs, c4aw j, rules an�yregulations of the San Joaquin Local Health District. <br /> n e d <br /> �-g ........ (Owner and/or Contractor) <br /> By ................. .... ......... <br /> *. . ........ . (Title ...... .. <br /> - _ <br /> (":)f plan, showinq size of lot, location of system in relation To wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> )PLICATION A.CCEf—'Eb F"r <br /> C <br /> DATE... ...... ...... .. ........ ...... ...../...... <br /> .;VIEWED BY ... . ............ DATE..................---..... <br /> .......... <br /> BUILDING PERK11T DATE......... ........ ........ ,_...- <br /> aerations ainO/or C -'e' <br /> 7 <br /> A .. ...... .. .... .. .. ..................................... .... <br /> .... ....... <br /> ........ ........... ............. .. . ... ............... <br /> Zit:4,1- INISPR-' ' <br /> T' I L)ISTRICT <br /> I JO South An- <br /> 4 105 W.v vth <br /> 5!ockton <br />