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APPLICATION FOR SANITATION
<br /> PERMIT Permit N 9 r7.
<br /> (Complete i Duplicate) e�. .......t ............ ..
<br /> Applica#ion is hereby mads to the San Joa .� I •47 �,e-�3 - 2.� Date Issued -f.. ..3 i�.7
<br /> This aPPlicatian is made in compliance with Local Health pis#rit#for a Permit to construct and install the work herein described.
<br /> P County Ordinance No. 549.
<br /> JOB ADDRESS-AND LOCATIO
<br /> .:-.:
<br /> Owner' „
<br /> s Narne.. f°�'1N.....�-f.._.
<br /> J o, �.
<br /> Address. w...-• «...t .J ,.-3 ._._.._. _._.. _... Phrne.
<br /> Co actor% Name.. _ tl:f� "',t i�l.....L�1.0-'v _- .,--_,-_
<br /> Insta :
<br /> llatian will serve: t ....._-.'.._-`. ..... Phon
<br /> Residence __...._.-....»_.-..
<br /> 1partment Rause �j Com
<br /> rrlercial ........ ---•
<br /> Number of living units: _F Number of bedroorris. -._ Q Trailer Court [] lti+lofial Q Other.
<br /> Water Public'•s to - Number •-baths _./.. Lot size
<br /> - +.. s� �.
<br /> 1pPlY= ys m'❑ Common" s tern 1..... _.._ .. .._.,.
<br /> fir system C� Prkate' Depth to Water Table .._.._.-ft.
<br /> Character of soil to a depth of 3 feet: Sand Gravel Sandy Loam
<br /> /� ✓Prsviaus Appication vade; Yes o Naw Construction: Yes �Cl
<br /> ay Loam[] C!a
<br /> Y Q Adobaardpan
<br /> Le []
<br /> No El FHA/VA, Yes ❑ No
<br /> TYPi OF INSTALLATION AND SPECIFICATIONS:
<br /> (No septic tank of ce "• - 1 , 1
<br /> spool
<br /> Perm if ublic l
<br /> t __. . P sewer is available within 300 feet;)
<br /> Septic Tank: Distance tram nearest,wcli r �"" • — .. -
<br /> ..1�__..._,D,stance from foundation...,�.+?� rv...Mate 'al_,.. � .
<br /> 1 tato. of comps+-rtmonts..,'�u.__.......... Size '� e
<br /> �-� +-.___..__Liquid depth_..
<br /> Dispos$I Field: Distance from nearest weil.,�f +er -'. 1_ apacitY--
<br /> Disfanfrom foundatior .!�-C>.
<br /> Number of lines_...-:.. 1 Distance to nearest lot line_,It?."„
<br /> • Length of each line.._... .
<br /> Type OF filter matarial =--._...-Width of trench,-._.m?.?{:!�-_. « s
<br /> :
<br /> 'Dsnt}t of fil er `
<br /> Seepage J'i#: D• s a
<br /> stance to noareit wa1! _`�._�' --•... Total lengt .... ........ «.__
<br /> I3is#erice £rom fozan rs t ««
<br /> Number of pjfs_ r da ion.-._._ . �,w. D"tame
<br /> Linin
<br /> _ q o nearest lot line....._....,...._• � !
<br /> Cesspool: Distance
<br /> from nearestwei. ._:•,A;.• ; e ;;:; izs• .p
<br /> h..............'.........: ,s . maunda#Size; Diameter...__-- Depth ion_.....#, v_Lining 'material.
<br /> 'j' Liquid Capscistanco from nearest well... ty. ..
<br /> ....:..,
<br /> :a._ _
<br /> ._
<br /> . ..gaIs
<br /> .Distance to near .._--.,_.__.,..,�--... ........Distance from nearest'buildin
<br /> est lot
<br /> -
<br /> 5 repairing (describe': , �� «
<br /> Ihereby c rtr #hat I hav _. __ .............. -........... .... _ ......» _....... ..._ .............------• - `j
<br /> ...... _. ._.............»...._._.....-__._.- ... i
<br /> e rep d this-a' of the that the work will be done in accordance with San Joaquin County
<br /> ordinances, Sta. la s, and ru and elation of the n oaqui Laca ealtlr District, _
<br /> ._ .._...__.._ ac
<br /> __..._. . _. .. _,..(rifle)- _ -� fir
<br /> tart
<br /> Pte.ung s of lot, location of system iri eelati o wel s, buile ings; c., can be aced on reverse......side). i
<br /> - ---- ,_
<br /> 3 FOR DEP TMENT USELON Y -
<br /> APPLICATION,ACCEPTED 8Y:; t --- --
<br /> REVIEWED 8Y,_,_,_. ...__ _..._. w«.....�_.......-.«__. DATE.N
<br /> BUILDING PERMIT ISSUED .... «.. . ...... _.._... .. DATE, AP .....
<br /> Alterations and/or recomrftndations t .. .,_ ._, ,•,__ .., ' T•.3.. _ OATE Rt1 ._��» _. .,_«.:_� l
<br /> ..., ..».. _ ............. .................. ....._.. .. _ ...... ,.... ..........«.�.«`
<br /> 11
<br /> ...........
<br /> _.-__... N � « � '_, ... .. ._ .a. � - W.«..�� •._--- :-.-..�„ .._...,w......- ---...� ..._w.i
<br /> J' r ...._.. ... .. -._.., ., ...._ . ... ,.!1 ...........................
<br /> ....... ........-._......4..... ...» ...».. ._..... .j. ...- .1
<br /> FINAL; INSPECTION '
<br /> ` ECTION BY:y .• �►- ......................... Date...'
<br /> SAN Jt'JAQUIN LOCAL HEALTH DISTRICT _..._.._._..._.w ,_,_...,,.,_,._ ...
<br /> i�6 Sauth almoriean Strae4 300 West Oak Sfiresfi !
<br /> Stot4toa, California 132 $ptamora Stroh 814 North "C•' 5traet
<br /> • Lodi, California 814
<br /> California
<br /> Traty. Cslifor"i.
<br /> "9"""7�• lievisacf 7.57 f.P%O. �
<br /> f
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