Laserfiche WebLink
FGR OFFICE USE: AppUCATl0�1'Fift'SANITATiON MMMf7 / 3 <br /> / per" No....'lf...» ... <br />...... !•°............ --• (Complete in Triplicate) •• • <br /> Date Issued.•.�1.'.��•:•7 • <br /> This permit Wires 1 Yea from Dale lewd <br /> olication is hereby made to.the Son Joaquin local Health District for a permit to construct and Install the work herein described. <br /> ......::�.; ::c <br /> application is made in compliance with County Ordinance No.519 and existing• Rules and Regulations, <br /> B ADDRESSAOCAT ,e,.. ll.. L '"�"' -...................... TRACT .�.......«...........�- <br />•ner s Name.. ...... ........................»............_»...... .Fllone••:Z• ..... <br /> City.......... .— ip».«.......••.�•--••-• : <br /> dress............. rZ Ij �.Phone��lun*1�1' <br />�traetoe's Norne........ license�►. jga F <br /> • Commercial Trolls Court ❑ � f <br /> itallatiom will server estd nce❑ Apartment House❑ <br /> Motel C3 Other....................................... ! <br /> amber of livinp'units,...........«...Number of bedrooms:...........Garbage Grinder............Lot Size/ <br /> r. .......»...................«....«..............-"---••�flrOt� t <br /> ater&tWp;Nrblk System and name.............»................».............................»......... ❑ CI loom t <br /> aY❑ loom <br /> Ianoetiir b , depth of 3 feet: . Sand❑ Silt Q CI Peat Q Sandy <br /> P�13 Adobe❑ FIR Material...... ....If yes,typ....«..».......».... .. <br />�,� �, ^� of in relation to wells,buildings,itc.must be placed a>Arwerertidrl .,� =-r� . <br /> pb!�; ������ k sNpo�•pit permitted if public sewer b avoibblevWthin400�leeul :� ^��,�Y <br />_"a -��a��yMA��1 ...!y- N0.Com .......-.-•«•..... � <br /> l•'k' h►4 r�' '`c•"•`ype.. <br /> •Q•Q......._..a.. ....f011mdOtiOm: L/.ti..«..i �Opr iww►�•�."1'!'. j A <br /> 04%@F'Unes ........length of oco fine. :.«.TotalV <br /> Filter Material».» •f Depth falter Moteribl«• .:"', «•�"'r <br /> neares>t Weil.«.�.pd...:...._..foundation.». �-•--.:-'..M :.ProPnq► r i,V : <br /> rtEpAGE MT;,. fin - pianteter« .....:........Narriber.......»_.».............:. J .� <br /> 'Wa1ebleM ».. _«........._...........«......Rock Sizi�«!f•„� 1` �V _ - <br /> D - We <br /> • ti .FaYndat10r1:.... <br /> to ...» ........._.prop. l�le.;......».«....�.......� <br /> MOfeftl Q... .�... ...I /•......_.......... ...J' r c. <br />■lpAllAjAbOflk�f�.I : <br /> ...«..« . .......................................................... <br /> . . .Sanitation Permit#:.».......»....«.............. <br /> ...«_..:..._«.»_.«....:.»..»:»................ <br /> Tank9 Requirementsl. .. ....................................... ...... . ..... ... » ................. . ....... <br /> lFwdSp fiRequirements)• .».....».............................._.................. ...».................. .......... <br /> ....... ........_....»..».».............»..........»......... <br /> ....«.........................«.•......................... ......»»....».«.». <br /> _ ...................»...........«_ :� 't <br /> "':..:...• ''�,��� ..�.«.....». . �praw axistUq and squired addition on reverse side) «....... �,y" <br /> IfM/I hew prepared d1�application and that the work will be done In atcerd"m w"b Sew Ie �� <br /> heriby tent► of the son 1eativin local ttealM DlsMct. ireele eMrner r <br />"nonees. flete•)Ours. and <br /> Roles Re9elarfeRs <br /> signature arMflee Me fenewlnDl eey p1. <br /> erserl Iw wth Iwewsler eY <br />..I that bj.�r perfemvence of the went for which this permit is Issued. 1 shall nor ernp <br /> Cern laws of California." <br /> re Iwo ,ebod to w » .......................owner ».... ,............................. ' <br /> .,. .:. ............. ........... Title... . ....... t.. <br /> of other thon owner) <br /> ' DIP MINT IiSt ONLY <br /> .DATE...... .,� .....»..... <br />,AppUCATiON ACCEPTED By...«..... ..............:...... ... <br /> ..............»................DATE.....«....................... .............«. <br /> rDIVISiON Of LAND NUMBER..............r. .......«......... .......«.......... �............».».. ..._.«..........._......._..........«....»........ <br /> rADDMONAL OpMMENTS..«.............. ...........»....».».....................»......«... .::...«..:.»....».«.«»..«..........»....» «...:«......... ' <br /> .. ...... ..a.....».«..... «..... ...... «.« ..«.« ......... .............ls• <br /> iti� ; E.-•.1 <br /> ..\' • � n. Pais �` k .. <br /> Yy♦� �p, jam- M <br />