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FOROFFICE <br /> rr-/��� ��- 1�� <br /> - ' -- / �- <br /> 11 <br /> ��� <br /> FOR��� SANITATPERMIT�� <br /> Permit No -�-�-�--- <br /> APPLICATION <br /> ' �� �m� �+m <br /> (Complete` ' &' �~v Date Issued --- <br /> ------------------------ <br /> _--__-' <br /> Application is hereby made to the Sun Joaquin Local Health Diof,ic+for u permit to construct and install the work herein described. <br /> This |ication is made in complianceh County Ordinance No. 542. <br /> Owner's Name--- <br /> Installation will serve: Residence Er--Apartment House 0 Commercial [] Trailer Court C3 Motel 0 Other 0 <br /> Number of /v/ng un/m: mv,nonr o, bedrooms .07-.. nwnbe, of baths .u-- Lor ^x= -�" -----'--' � <br /> Water Supply: Public system Community system El Private Er"IDepth to Water Table .5.40 ft. <br /> Character of soil to a depth of 3 feet: Sand E] Gravel [] Sandy Loom El Clay Loam [3 Clay [] Adobe U"Hardpan F] <br /> Previous Application Made: (if yes,dcite--------------------I No E] New Construction: Yes [:] No [Er""FHA/VA: Yes No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public-sewer is available within 200 feet.) <br /> Disposal ield: Distance from nearest well-S;0-'t-----Distance from foundatiort--A.,o.........Distance to nearest lot line- <br /> Seepaqp�pit: Distance to nearest well-/046---------Distance f- f d t' ......Distanc <br /> Number of pits-­-,/-------------Lining material­;;J��­..Size: Diameter-------�u-----­­Depth.......2,e�'g.............. 4 <br /> ' ~='""°""y and/or '"p" 'y p"^°''"e/ ---------------------------------------------------'---'-------'--------------'---------'------ <br /> ---'-'`'''`'-'''---------------------------------------------------------------------------------------------------------- ------------------------------- ...................................................... <br /> ---------------------------------------------------------------............................. -............------..------------------------------------------------------------------------------------------------- <br /> ----------------------------------------------------------- _..__-___---__'_''_---__-.---.--.-_-_--_-__-_---.__-----' , <br /> er"fif that I h)ave pre�ared this pplication d that the work will be done in accordance with San Joaquin County <br /> y u 41 red jln� <br /> ordinances, ta a a�wVsn ry4d qu at, <br /> AA regul ti s of +he Joaquin Local Health District. <br /> , <br /> BY:--------------------------------------------------------- <br /> � <br /> FOR DEPARTMENT USE ONLY <br /> REVIEWED BY--------- P <br /> BUILDING PERMIT ISSUED-'_-----.---_ ' . -' -- -- DATE---.-------- <br /> � <br /> � era� � . <br /> 6"umn�/*rre��mmwn�� �n��-.����� ~' ��.-`��°���-x���.--. Z - -----------r-,--_--- <br /> ----------------'---'---------------------''---'---------'----------------'-''---'-'' <br /> , . <br /> '-''-'--''--''--'-''''-''----''''-''---''-'''-''''............------------------------------------------------------------------................. ...... <br /> ' <br /> m.----------------------------------- ------------------------------------------------------------------------------------------------------------------------- ''----------------- ''_''--''--' <br /> ~� <br /> -._`-----------.----_-----_--------_-'_-'_--_-_-.-----_-_------_---.. <br /> HN/\L INSPECTION ���������--------. Du+m-.'� -.^���.��.f�'�����..�_---.-.- <br /> / ��W J���U|N ����L HEALTH DISTRICT <br /> 130 South American Street 300 West Oakovr*ot 1o*Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> Eo " REVISED ""p "w 5-61 ATLAS <br />