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� `FOR 'APPLICATIONAPPLICATIOFOR SANITATION� ������ Permit N <br /> ' - �n �OWokcaf� <br /> r-~ ^r~'- --- Dote Issued- � <br /> plica+ion is hereby <br />' <br /> mo6a to the Sun Joaquin Local Health Dstrictfor� u permit to construct and install the work herein described. <br /> T6is <br /> application is made in compliance with County Ordinance No. 549. <br /> Om ��O m.� -_-'-'' ' <br /> '="'e"" -" ~~ ~^ '-----'------'-'---------'-------�7.---------- ' <br /> -- . . -~ . ��^ � � � �. � <br /> Contractor's Name-------------- --K�,�r����.--------.-------------------..�-.. rxnno�oe-z--'^e.=-.-'... <br /> . -�~�� . <br /> Installation will serve: Residence @� Apartmerif House - Commercial E] Trailer Court 0 Motel Other E]Num6o, of |iving units-. _/--- Number of bedrooms Number of baths J_ Lot size _ � --------------------- <br /> Water <br /> -~____- <br /> Wato Supply: Public� � om [� CommunMy system [ P�vufnoz ^b nPfh to Water Table /=10- ft <br /> ' <br /> Character of soil to a 6amt6 of 3 feet: Sand E] Gravel E] Sandy Loam E] Clay Loam []' Clay [] Aclobe R-lHonJpuo [] / <br /> Previous Application Made: Yes No PR *'-NewConshuctivn: Ye, ~~~�'o El <br /> . . <br /> TYPE' <br /> OF INSTALLATION AND SPEC|FiCAT|ONS: ^ <br /> � <br /> (No septic tank or cesspool permitted R publicsewer � available within 200 feet.) 0, C, alc4t,' <br /> 11- 1 <br /> Disposal Field: Distance from nearest well--474?---------Distance fron� foundation---!;�4� ---Distance to nearest lot line----1__�----------- <br /> I hereby certify that I have prepared this application and-fhat the work will be done in accordance with San Joaquin County <br /> ordinances, State laws,,and rules and regulations of the San Joaquin Local Health,Districf. <br /> 04er and/or Contractor) <br /> --------------------------------------- <br /> (Plot plan, showing size of lot, location o f er in in relation to wells, buildings, etc., can be placed 6 reverse side). <br /> st <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY. --- DATE---- <br /> --------------------- <br /> Alterutionuand/or recommendations: ------.- ------ ------------------- -----------------------------------------------------------------_--_---_-_____. <br /> .--_--_---_---'_..------_------------'--_.__._-_-----'_._--_--_---._'---__._-_-- <br /> '-'-----'----'''---'''---''''-''''-''—'''''-''''----''''--''''-''--'---'''--'---'-'-'-'--''--'--'' <br /> ._----_-_----_-._-------�__--------_---_-_--_---.-------_-_-----_----.- <br /> '_'--'''''''_�'�''-''_-'''---'''--'''--'~^--'-'-_-'-''''''--''_''-'----------------------------------------------------''-'-- <br /> ) <br /> RN/\L-|NSPECT|(]N-BY:_A�.��.�� ----- Dote- ------ ------------._--. <br />/ <br /> 5AN JOAQU|N LOCAL HEALTH DISTRICT <br /> U /m south America" street 300 West Oak Street /32 Sycamore Street 914 North "C" street <br /> Sfo"y"". California Lodi, California Manteca, California Tracy, California <br />| <br />