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I-uKOFFICE USE: <br /> ^ - APPLICATION FOR SANITATION PERMIT Permit No. ���-m:'^�.�� ' <br /> | - (Complete in <br /> IssuedApplic �������.�� <br /> = 6u* <br /> i <br /> This applis ication ..�~~ to .. ~ /�nct�nmpmrm� +ocov,�vc �nJ �mnU�*�o, herein <br /> ... up��unon mmuuw m compliance with County Ordinance No. 549. � " =� ' <br /> ' 4�pW�. *- <br /> --------------- <br /> -------------'~'~'~~----`-'-----' ,"pne-�.v^e�-2��-c-��- <br /> Installation will vpmm^ Residence [] Apartment House [] Commercial [] Trailer Q;Mtm �� ~^'~' <br /> � - O ' <br /> Nunn6ornfliving units: ^�. Non`6nrnf6o6mom, - '/ <br /> . Num6orofba+hu -.�� Lot size <br /> ' ' - <br /> ---'-- <br /> Water Supply:, Pu6Publicsystem [DCommunity system [] PrPrivate «z Water Table <br /> Character of soil to depth feet.- Sand [] Gravel [] SanJv Lo*no[] C|wy Lourn [] C|wv [] /\6o6o�'�uo,Jnon <br /> Previous App|�a+}wnk4a� ' ^yFv�:��&m^---.---) No �z-^ New Con,�uct)on. Yes [] No [] FHA/VK.--Yes [] mo [] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No ^epMc tank or cesspool/ 'ennfij R public' sewer iavailablewithin200 feet.) <br /> Se pkDistance from found ation-1114 <br /> - <br /> No. of =o=p"��enn' ' <br /> Material <br /> - <br /> ^ <br /> S! xzx-s-x- <br /> -- - - <br /> � �4� Capacity F/o|6� 11 Di � �o- - � <br /> -- Number of lines- <br /> . ',p° of filter material.. <br /> � �+- —' of --filter ---- °-9' Total e"e��' ��^� <br /> Seepage . Distance to nearest <br /> t ' f 1`11 founcla+ion../-�17 L. stance to nearest lot line <br /> . ^= -..~~ ~. p.`--�_-_"nmg Size: �ame+e�''�&���--Dvpf�.'��"��^--.'-- ��~ / <br /> Cesspool: Distance-from nearest ' ---'-_Distmnco from fouv6*Mon--_--- Lining material ~ ` <br /> LJ <br /> Size: Diameter <br /> ' id <br /> Privy: Distance from nnvn"t woU ______-___----.Di Distance from ~ <br /> no°noo� <br /> ...........................................................Distance <br /> -r <br /> l / Rmodning uo6/o, repwir�^q (describe):-- <br /> U <br /> . ------'--_--_--'_.-_''--'------.'--_.---'------_-'-_---_-_.- --_''-'_ � <br /> --'------'----'-------'---------------'-_---- -----------`---'---' | <br /> / hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> j1e an Joaquin Local Health District. <br /> � --'-.--. - <br /> [ � <br /> ^ (P6+ `By'-----------' --' ------- <br /> lot <br /> � . _ ze of _. location_ _ _ _,___ _ relation .. _�" buildings," em~ oon m� p��wu wm r�re�w si6w). <br /> ' <br /> FOR DEPARTMENT ' <br /> . ° 1 <br /> � ^m� <br /> | '- ' -^~`'^~'` '^~~^ '"' "'--'—.-peo� ------------------------------------ ��TG' '���. ��.�� <br /> xemEVvED B� - ' ....................��TE- <br /> BUILDING PERMIT ISSUED.................................................... -'---'-- ---.--------'----- <br /> � Aw*,�ionuand/or n�ommen6=*v" �-.- ---'----------------' ' <br /> --'----�'`-_---'--_______________________._______ __ ......................................�--- ---'--'-----'--'---' . <br /> \ � ____________.______ .______--________________________ _ _ _________. ___ .� -''-----------------------'----'----'------------'----'--'-- <br /> | ----'-''-'-- <br /> . ^�� <br /> | . <br /> FINAL INSPECTION WY�-.�nn�.��----- ---- Date'-.�3-77;� �� C5 7 <br /> -_'-'-__--_. <br /> / SAN JOAQU|N LOCAL HEALTH DISTRICT ' <br /> /^w, ��zellon Ave. 300 West Oak Siroof 1m����Street �����w�� <br /> � m"�m° cwx"m� �a c"u��� o"ofo=/� rra",.o"ofe,"/" <br /> ~=C" <br /> ~ <br />