Laserfiche WebLink
f'. <br /> jY Dot* <br /> !s: Date Issued ..7.1,(..1. o <br /> AF01lowlim is hereby ode to Q*San Jaeq,rin Local Hedfh Disfrict for a permit t..j rruct and install the work herein dowilmd. <br /> Tom dppkalipr. 4 nods iin 't14 Qrdinante No. 549. <br /> JC4 AO MS AND <br /> ................................... <br /> �.................. <br /> � . .. "?11 _... ._..._.......... ..... .............. ..... .. ...... ... . . .. ...............� <br /> N <br /> ----............................. <br /> +/��' -----�- ---..i-•�......__.-1111...-1_111... 1111.....,.r.......................... F--1111... ........... Phone................................... <br /> 1uMolls WO WN WMW Rasidrrsoe 9rApartment House ❑ Com.iweial © Trailer Court ❑ Motel ❑ Other [] <br /> Nsswebar of liYipq ssslih:.../_ Nssnber of bedrooms Z. Number of baths ..1... Lot size fa.�.-�/�.7_... <br /> woe► SN"611 fss k e dam 0_'Conurss*;fV sYstam ❑ Privato❑ Depth to Water Table ........ ft. <br /> Thr <br /> of 9A to!4"A of f fsvk Send❑ Greve!❑ Sandy Loom❑ Clay !cern (] Clay❑ Adobe&`hardpan❑ <br /> t hwiiws Allen blades Of Yes dote. - l Plo�Neter Construction: Yes l�No ❑ FHA/VA:Yes Q No <br /> 1 Y1� OF 06TALLAUON ANO WSCMATIONSs r A <br /> If f?AAC sewer k evaublo within 200 fret,) "1 <br /> Septs' �iarik: Dstance frown neamt ..ell.",,.... ..Distance from foundation/p........ . .Material...•I zrLt ct+.�.. ........... <br /> �t1....., Srta... X �... Q f. .. p ty...d ......� .k.a <br /> 1111. <br /> Nand: Distarsca frons rsaarest wet! Di t <br /> f ......_ 's wr+ce from FoundotFQn../.Q... ........Distance to nearest lot line..�...�...... . <br /> `l W dth of trenth....� ' <br /> Nornber of lines LangM of each line... �. fes.'.................... <br /> Type of fiihr nsate*iad... at.�..... Depth of filter meterial.•��, Total length--90.......................seego ....... <br /> rrt: Dio"ce b.aeras! wen.,-:..............Dist,." from foundetion.Lll.......__.1 stance to nearest lot Iii <br /> e...`.}.......-... <br /> Nvobar of Lining n+oteriai..f " f(,., Size: Diameter - ..h... ....Depth. ..-.............. <br /> 1111 <br /> Gesspock Disten" from ra*rest we41..............-Distance from Foundation Lining meterial.--........,...................... <br /> t ❑ Sixa: 04MOhr.,... ........Dec#h....... ...U,4uid Capacity.......................__gels. <br /> { <br /> ± PrirT: Distance fro,,, rawest wap Distance from nearest building ....................... ....... <br /> t <br /> ❑ Distarw t0 Meretl IOL lire. . ... ........ ...... ..... .......................................................... <br /> t <br /> I <br /> ! Raont�delee*g and/or o*pes'ng ',describe):. ................ ...... .......-... -....................... .......____------..............---..1111 <br /> .-.-....11.11.............. ...... .. .- ... ..-1111. .... .................1.111..1........................... <br /> '""'�`e.'``". ._. ._. .........P,�d....... .......... ..... ........................................ .. 1111... .-- •.....-.....-.---.......... ....................... ..ti <br /> I ' tlsat 1 las e 6 a Dad AM The work will be done in accordance with San Joaquin Cam <br /> a_"----- ata la.s, and rrbs aid regeddioft the S.n quin Local Health District. <br /> ....... ., 1111. 1111... {Owner and/or Contractor) r <br /> �:.... <br /> ........... ..- ........ .............. ..... Title). .. .. 1111- <br /> (Pot Pow, sfwwinq siisa of 61,location fem in reLefaw to wells, buildings, etc., can be placed on reverse side). <br /> USE ONLY <br /> DEPARTMENT N -_—�.-- <br /> APFUCATION ACCEPTED 6Y L ` ,c G .. ...... ... �.� E.. %1'111 C�-.�.:;�'........................ <br /> AWFWED BY . ... ..... ... DATE. .. <br /> . . ... - -. 1111... .. ......................1111...-1111-..----......... <br /> 6UtLD0* fERM,T ISSilEO. . .............. ..... ..... . ... 111.1...... .......................... ... ... DATE.. ._111 1.................................... .�....... <br /> Abwellewe rood/a► .oaeesarsrtdatfarrss„ 1:111-.- . ........... ..--....-............... <br /> -f G. - f /<. ............................................ <br /> ..... ... ..........f.... .. . 1111 -.......... <br /> 7- �7�►•.�' ��a./ � j•"IF,,.. C--fs.�.•.y-�.- /Y� % 1111---- •........... ....... .......1111. <br /> 1 V <br /> .1111. <br /> t r,�.L irvSpiCTlnt, aY f' /'ra-t: •�' Da+c <br /> SAN JOAQUIN LOCAL HEALTH DtSTK.:` <br /> tie 16.4%Ii..a we+W~ 10v wo.c oea fret 124 srcws..:,rMr 205 Woo"St. <br /> 1..~.[e4c%." "4t,cetifemin Catilo­a Tract,coiitornin <br /> i <br /> t <br />