|
q
<br /> APPLICATION FOR
<br /> WILLIPUNIP
<br /> SIN JOAOUIN COUNTY PUBLICHEALTH SERVICES k,"- .i_ _m
<br /> ENVIRONMENTAL HEALTH DIVISION
<br /> P.O.BOX 388,304 EAST WEBER AVENUE,STOCKTON,CA%MI0 88
<br /> ,gyp r1 120914803420
<br /> NOR REFURDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED
<br /> IC@mOMb IR T POLEI.)
<br /> AMICAMN Ip HIM BY MAGE 10 THE PAN JDAOUM COUNTY TOM A TENANT TO CONOMMT ANOkp INCTAll TIIE WON{MOC1VBF0.THIS AFMMAMN IB MAO[W COMRIAMF PITTH BAN E
<br /> MAOVIN COUNTY IMMIOIMFM TNIF.CHAPTER B-1[16.3 AM THEBTAMAMS O[RAN JOAONN,DUMMY WBUC IM ALIII eM 19.[NYRMIHHtwµHEALTH.... 1.00 qas
<br /> l JORAOnnee.M,W[ 1722kFkkA STiz6,-r c-, S'COCKTOM PAMW /y/O [
<br /> RWWA [ •9n-0[�nY Z
<br /> owrrtH.PFME A.... w'rr,en bLBp nroM\402-451-Btnp �'
<br /> �+Nwla Ton EJyYiQI/+JE(J,¢ (mFll54L>]WTS AIMnFN /673L PA�mQro D¢. m, A//R nMMEG14-GIb-aFyb
<br /> PUB coMMM,on WEgrr tMEMAT nr-IL!_JAJy APONFP "�IS^9e�CM�l.�CBIkF 5 97 NMM[9/b'638.1276
<br /> 1
<br />�" lYR 0[WFLNVMN ❑NAV WftL ❑nFMACfMEM WILL ❑MONI,ORMO N4Il1 OTIHP [nLL
<br /> [�
<br /> 11 LA 11 WftL IY.IFM11E1A1p ❑CMPPLONNFC,REPAIR ❑VAT CVI MCM WEfII
<br /> J
<br /> �FT
<br /> 11.-0O 1, ".I.- OFPTII WMPPn�R. "' TMMWAnp L[VEl O
<br /> r- NYR OF WMPI
<br /> IlilFl ❑IMM.1.1. kl WFu ❑D[DNnccAL Wfu[ )S Part MNHO 7ML OF V e
<br /> 1JM1MT VCTMH;
<br /> I
<br /> NI DEO F_ BnAIA,b YPEO W COM,RVCI OX EPEC NCAI ON[ A
<br /> ❑RfDUBTNAI V Oortu eonoM pi IA VA.OF�,OSe,VL RJJ VA.OF coHouclop PA. Al//F BB
<br /> ❑DOMFBTM.N IE ❑BMVFL PMpNOF TYF.1 &A pI A.BF WE II CAPBM
<br /> ❑nlBlkrMIIMCMµ �❑IONVFN efn110FpMMBUI VOF.G-G,/ G(QJQJ.� SMCIFWATMN R
<br /> 11 pmroAlMH/AO pOTINR µydPoplMNnti OMVT BIAL.N.IAILM BY DRItLER BMM BMNO NAME F
<br /> �MBMIORMO (• [' tV MPUIWMIB;WY- [I. CONCpFIF PFOFPTµeY OMI[R:DY� ON. 6
<br /> APMBp.nfRN E�{,/'1,2-1e Ifoff. LOCRINO TNI.IM eOFMTOVF NR mZ4 .F
<br /> BBOPOE[BCOHF,BVCnONId[IIMO MRMP. MIIO MIARY Am MIABY AUDI. 1ARIF. TMN1M
<br /> IHARPY CfMHY THAT I HAW PAFPARFB TTP@AI A,MN AND T,UT TIM MMS WILL
<br /> .1 BOM M ACCOMANCE M1tNSAN MAWIN CVMYY OMMAHCFB.STATE UWB,A.VMS.AM
<br /> MOMNAlMM OF TIM CAN JOABVM COUNTY.IMMB
<br /> F WNEP OR tW tMFO ABFM'@ @IBNAIVBE CERT..IEE TIM FOLLBWl11P'I CFMIFY THAT M TM RWONNANCF OF THE YAMW TBR MUCH
<br /> !IX@ IEmAII IS ISNFO.1 e1Mll NOT FMRBY M....BNN.cT,O WOPXMAN'S CBMPFIISAFMN LAW@ OF CAIWSHA 1A.'COMMCIOR'S IPNNO OP WB{OMMCIMB MONAIVRf C[MRIFe
<br /> ,M FMON M •ICFMIA'THAT IN THERMOMIAME OF TIM IMM FOB MST" IBBI'FRMNNIeSU[O.IS.It WIND,RRMNS BM.J[CT,O MORpMAN'S COMIdEA00N UW@Oi
<br /> CAUHIMNN;(�T�M�AI�NICAN(I'M�BFT CALL[A NO W E IN ABVANC@ FOR ALL RFOLM[S INI RTH N@ AT 1N1 A@@.NMB,COMnFtI OMWMB AT IOWf11 ARA TMVM[O.
<br /> 1. ea•.ep�AL/IIh��Y " IMM at✓yE2i G.sIJ:e1.�.-- 1/1617
<br />• ne,rtARRA—1.@e..,..ln_L•I[ 5b,
<br /> 1.HAMEB O1 @HOnS OR ROµle MAMBT 10 BB BOUMMAS TIIE nMRpry, A.LOCAIMN OF HOUSE Bf WADE dBW BµDYR[M BB I'VHB.,D
<br /> OMUSM.,INS....BIVPM OIMFNBMM AMO M.MVFC MM [RPANBION OF SWAO[...Al eMTf4e.
<br /> dMEN[MM0 B VTL NO IOCAT .1 All EPIAMp AM Mob.HT @.l C TMN OT YMTLS WIT mJ KA..Of OM I.. I,n.
<br /> ep.,IVF@•INCLVOIIM CCYIMMB AREAS OUCH AB PAIMe DnVAVAYS.AND WALKS0.1.1 nMRMY W1AOMININB MOISNTY
<br /> ,
<br /> I'" PER3E-.SEE A-7I" caE'F'-A F/GtFR£s_. .. '. .._ ,
<br /> T. fgrArTJ
<br /> Z F, ure 2 �;de Pl/late
<br /> I ,
<br /> �`' ^ n[P.,•fP[HT 11.,IT
<br /> BnlneOsn Mnae,lm py I
<br />)))� AMPIMMINO BMY; AMI FAC*
<br /> P[COOFI F[EIMB AMOUNT PFMt1FB CI R* AFN RECOVEO BF DA![ P9WIINFFINC[11[l.,FJMMBN ,NyO,CE
<br /> 11 Pub.HBBOh$SN.-EMtO.173(3196)
<br />
|