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APPLICATION FOR SANITATION PERMIT 473 (Complete in Duplicate) plication is hereby made to the San Joaquin Local Heaith District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION---t_._..� eeor :Aire. IlLf ----------- ------------------------------------------ ------- Owner's Name--------- ) --1�.` JCMI-------------------------- ----------- --------- --------- ------- -------- Phone_ 01' ------- �-------- Address____. Section_ AV**. ----------------------------------------- ---------- Contractor's Name------�•, 1.: ! ` BYI;—&' $On ' - ••-----••-------------- ---------------- Phone_..9�_W,' rtstallation will serve: Residence X Apartment House ❑ Commercial ❑ Trailer Court Motel ❑ Other ElNumber of living units: 22001- x. 200 ' Number of bedrooms F- Number of baths [ Lot size--__ _.__._. Wafer Supply: Public system ❑ Community system ❑ Private Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑. Sandy Loam ❑ ClaY Loam❑ Clay ❑ Adobe ET Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well_..W!.1.--, �oncret& • Distance from foundation_. . __.. Ylaterial_______________ __-_____ No. of compartments--•--•-•••'Z-: --•-.--••-Capacity- -0------•--------Siz =-7F - 1N--- -------- ------------Liquid depth.......... .............. -Cesspool: Distance from nearest well.................Distance from foundation__ ...... _.Lining material------ -------- ---- 0 . Size: Diameter Depth •----.•-• •`'=- Privy: Distance from nearest well------------------------------------- - -_-___Distance from nearest building-_.- - El - - Distance to nearest lot line......................._........... Seepage Pit: Distance to nearest well_-... _____________Distance from foundation-- -------Distance to nearest lot line_____ __________ 1 ❑ Number`of pits....!--- --- .....Lining material-----------------------Size: Diameter---------.-.-----,-_._..Depth_. ..... ._. _ ?._Disposal Field: Distance from nearest well:.._ 101 1 '$1° �1� ..-Distance from foundation ..__________ ______Distance to nearest o line. :_____...___ Number of lines----3L.... &..W...Length of each line...._O)" t #ss' 46W, Width of trench.. Type of filter materjal....................... --Depth of filter material and/or repairing (describe)____________________________________ -- ---------• -•---••.- - ............................. --------------= --------- --------- --- - I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District, (Signed).........D*AA.t..Pazr1ah-,..&.SOAH •:: ( nnd�dr Contractor) - --- ------ ---- ---- BY:--------Ofto_._8_chambe3i------- ---------- ---------- ----------- --- (Title)..E8t-1X'ILtOL--^------------- -- (Plot plans, showing size of lot, location of system in relation to wells, buildings, etc., must be filed wifh this application). OR PARTMI7_� Y APPLICATION ACCEPTED BY. �1' � j --- - - DATE--- ----- � /� ` F t EVIEWED BY ----------- ----------------------•----- -•--------- •--•-----•-• ._ DATE__.---------. . BUILDING PERMIT ISSUED-------- ---- --- f ------. ••-•----- . ----•------•------- --------------------- -------------- DATE ......••--- Alterations and/or recommendations:_........- ----------------------------------------- - w-------I--------- ------------ PERMIT No._. _-_,�__3-----_ ISSUED__.__--- _--�Q-/ .........(Date) FINAL INSPECTION BY:...._`�-..� Date---- - .� . SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 9-2M 9-50 W=1639 Stockton, California