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rY FOR OFFICE USE: <br /> .. ............ .-............. ..........----- Permit <br /> APPLICATION.FOR SANITATION PERMIT <br /> . .... ............... .. .. (Complete in Duplicate) Dato Issued <br /> ........ This Permit Expires 1 Year From Date Issued i <br /> ,App':icafion is hereby made to the Sen Joa urn Local Hea fh DistrF <br /> rct for rrnr• to construct end inste':I the work here'r. described, <br /> Thi: a plication ZD__ <br /> ode i corT}�linf^�14 <br /> rfC ` Ordtnancrt No. 549. <br /> i47WE 5 AT10N - �Z er"elsow ..... <br /> Owner' Name. � •D.71./ ........ >T. <br /> ;f,(,/ - _. Phone_- <br /> Address �. 'L. L.......577. - .._.. <br /> Contractor's Name.. .,Ll c.�/•-. ....f..�j�/., /7.. .. .. /�5.�. .... �f%v...... .... �hon9'i��6.7.6!e <br /> Installation will serve: RCsidonce [��Apartmert House ❑ Commerr,'al ❑ Trailer Court ❑ Mctel ❑ Other ❑ <br /> Number of wing units; ..l Numbor of be rooms <br /> 'i Number of na�hs _. Lot size /`!!hr �o . - <br /> Water Supply: Public system ❑ Ccrnmun'ty sysfsm C'1""9rivats @ppth�t 'Je•er Table/Q_ ft. <br /> Character of soil to a dopth of 3 fent: Sand ❑ Gravei ❑ Sandy Loam D Clay Loam[&-<-lay [] Adob©❑ Hardpan U <br /> Previous Application Made: 11= yes,dote ; No New Consfruc-i0:1: Yes [I I`lo fes--"FHA/VA: Yes [j 110 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: • - <br /> (No &optic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: D1.9-arce �rern nearest wer ' Distance frofrl touedat- --------= ------Malar al....r`M^ . --- . - .- -- -- <br /> ........ <br /> Nu. o- compartments -------�._.._. size........ ........ _.Liquid dPp+h t�. LeUaCity. ... -- - <br /> i <br /> �A Q <br /> Disposal ield Di terce frog, nearest we.IJ 101 1 <br /> 9......Distance from founds•tan" ici,th •t nearest lot line..... ......... <br /> _.---...- Length of each line-- /O� � Width of tre x:h ��N...," <br /> Number of inCs �/ � ,r <br /> • Type of fiber material... 'F�� De th of f iter materica <br /> Total longth�.... .. <br /> P (� • <br /> Seepage pit: D scarce to nearestwP:' __ Distance from ioundatior._.' iJistar ce to nearest lot line............... <br /> l ,s <br /> ❑ Number of pit, 440"' Lin'nd material.... . C:aTeter 1 - .. _Depih.............. . .....- - <br /> !C' <br /> Cesspuol: Distance Tr-o-7 rnaras+ well.-.;.-.- Distance frcrn foundation . Lintrq rrttAnaf................ ................. <br /> ❑ Size: Dinrr,cter..... .......Depth .-----•---_- 'quid*Caps icy. �_ <br /> .1 . <br /> S V ; <br /> �--`�fFivy' - L�istance.f om ceases• well. " "-.---,--. ------.._.... <br /> ..Dist from nearest;!uilding .."..... <br /> D;starce to nearest lot line........ _... .,. ._. .................. ................... ....... �{ <br /> _. .. <br /> P,emoaeltng and'or rr•ci3ntn ... .� ----..... - -- --- ..---------•---•• f <br /> _ ' .r' ...... <br /> .. :..:...._.. r-�.'... ..._......... ......-............... ... <br /> _......_._......................... <br /> !, <br /> .. ........ ....._ <br /> 1 hereby certify the+ I have prepared this application and•t�Ti'at the work will'be done in accordance wif_h.San Joaquin County I <br /> ordinances, State laws, end rules requ{ations of the 5 J qul Local Health District. <br /> end/or Contractor) <br /> (Signed)..... ' <br /> �,.+*­i.`c.� .,O�f`lvlierri <br /> By:.IPlo+ plan, showing size o , in relation to wells,.buildings, etc, can be placEd on reverse side}. <br /> � Y: <br /> FOR DEPARTMENT USE ONLY • <br /> ----- ....-............. ....... .................... <br /> APPLIC„aTION ACCEPTED BY `� I DATE.. <br /> If DATE.. ..............._......................--------- ..... ! <br /> BUILDING PERMIT ISSUED I ......................... ........ ......... ....... _ ..._ .. - .... ....................,• ..- ......_...... <br /> ................ <br /> DA . <br /> } Alterations and/or recommendations: .......... ................ ....... i. ...-........... ............................-........".---- ....................... <br /> +�..�- .- 'se`s: _ •• -•-•••- ---• .. <br /> ...................... ...................-_..... ................ <br /> .......--.... .............. -- ------------- -- ��.�..i .•: tt.. <br /> L ................................... <br /> ...•• --- - -------- --- <br /> t !� _ , J <br /> . _............... . <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> t 1601ff Noxmiten Ave. 300 West Oak Sttewt 124 Sycamore Street 205 West 9th street <br /> Slachlen.Collfornio Lodi,Cvlifor :a Manf*cv,Ce7ifornie Tracy,Cvlifarnio <br /> r.r.cu. <br />