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- <br /> � ^ N FOR SANITATION PERMIT— <br /> Permit No. <br /> (Complete in uw�|�ato) �� / <br /> � x ` Dofo Issued -'. "� <br /> ` ' / / <br /> Application h6er �v made to the San Joaquin Local Health District for a permit to construct and install <br /> / <br /> This a plicafion is ma the work herein described. <br /> p cle in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATIO <br /> � <br /> m�o� mu ~� <br /> Add <br /> / <br /> .). R ' _ '--' ..— <br /> ~'---------_-_----_--_-F'm-=on=o=,-=04�--[�]�' <br /> v---�-y' <br /> --��aU��n ~@ serve: ��e�e � �mo f House [] Commercial � Trailer Court [] Motel [] OtherNum6ar of living units: 'Number '.w-4-"Number - - --' `~~'~Watwr Supply.: pvW|c system L - <br /> Community system [] Private fn \�oto, Tu�o,��/:�T <br /> Chunocfn, of soil to a depth of 3 feet. Sand [] E,u"e| �� Sandy Loom {]uy Loom [� ^Clay �' Adobe Et—Hardpan [] <br /> Previous ApplicationMade: Yes []| No ��~~-^ew Construction: Yes [� No /\/VA. Yeo ' �^ No E] <br /> TYPE ��F INSTALLATION AND SPECIFICATIONS: <br /> �� -- <br /> (No septic tank or'cesspow| permitted Rpublic sewer is available within 200 feet.) � <br /> Distance from naare,+ �aU-----.-'Distance from <br /> � - [ foundation ----�Mofe,ia|No. of c�mpu,��on/s --------''3�e ---'--''--Li u/" deP�»------_---C---'----------------------------- <br /> r <br /> ---- <br /> ----- <br /> � <br /> / r ' — pnc�y----------------------- <br /> Disposal <br /> Distance from nearest well <br />` �� - ---- from '~`^~~^~^­/= --°°mnc� n, n��no� �� ono_ ~" <br /> ------ <br /> Number <br /> of |ina,�| ~ ~ , ` | <br /> '- <br /> ne <br /> -.'� —. �ngfreach k -~-'---' -' ~^' ~' french aTvpo of filter material..�� *& �°°��". of ���, m°rer'u/_. � � �_|ofo| <br /> Seepage Pit: Distance to nnop�f ���'-'---''''Distance from foundation�- -'--' -Distance to nearest |o+ line[] Number nfpits----------------------Uning mufe,iaL____ Size: Diameter_ "�pr| ---,-----'------'—''' <br /> ti�n--------------------�n�q mota,�|^ ''--''�-----�Cn, pooL Ostance from nearest well--'--'-Distance from fuo 6 <br /> E Size: Diamuf c '------ ---'Depfk ^ -''--'''-''''''-_.-Liqui6 Capacity----''-'-'--_gn|,.privv Disfanov from ,�an`t v=K. ----------------------------------------- <br /> u~-\ <br /> \ <br /> � <br /> from nearest <br /> ' <br /> ----.-_-_--�uU'_--6--'��------g_-- <br /> _--- <br /> -_- <br /> -D|dvnce to nnanef lot |�e''--'____��_____�____-___.__ '—'._--'--.---_'-_---'----�' <br /> Rvmn6v|� and' or repairing ---.--.___'___.---__-_-.__--� / <br /> --'---__--___.-�.___..- _ -_^---____.------__`-__'---''-_'-_---__-_.- <br /> __--__'--__� <br /> ---_ <br /> ordinances, S ale- ws;,. and,r les and 4re u�lafions offhe San Joaquin Local Health District. <br /> (Plot plan, showing sIZ6 of lot, location of system iqlelafion to wells, buildings, efc., can be placed on reverse-�''-'--_' <br /> ^-.'-�-''---'''--'__--__-��.-_'-_-___-_--_-.__'-_.--'-----�_-'_--_-._-- _--''--' -�''' <br /> . <br /> --'�'-_.-'-'---_-_-___-' _ _-.'___.-_.'''-'_ <br /> APPLICATIONFOR DEPARTMENT USE ONLY <br /> ' -^E, .E" - �_-.-�---_-_--__ - DATE � -REVIEWEDED BY ~-- <br /> \ <br /> ^ -�-------------'- '''--'''-- DATE0U|LD|NGPERMIT ISSUED----------------- ---- --_'_-.--. _ --. -- _ -- -' ^^ANe'ut�nsmn6/o, ,ecommend*f�no .'__.�____._______ <br /> _'--'-_'--'-''_-.'-�.'''_-`�'''-'''---'-_'''-_'''--_''- . <br /> , _--_-_-._--._--__----.--.--_- <br /> �NAL |NSPECT.. ,-^�- �---- -..z'.r��+ Du+a ---'-'-'_- —_' <br /> SAN OAQU|N LOCAL HEALTH DISTRICT <br /> 130 South Am°w"° Street 300 West o* Street as Sycamores*°w m* North ^u^ s+�°Stockton, California Lodi, California Manteca, California Tracy, Californiass--9--2w . n".is°^ 1.57 r.pcu <br />