12508 - Laserfiche WebLink

Home Browse Search

FOR OFFICE SE:`/' _--- r j/ �_ ',�"---'---.-�'--%- -------- Permit No. ..��.:�--� APPLICATION FOR SANITATION PERMIT - - ---•--- � ,It (Complete in Duplicate) __ ..Date Issued-----= :�-( '••-4. rmit-Expires 1 ear ate y _ .b made to the San JoaquinLocalHealth Distreict forperm eDrm t to cgndstrucfi and•.install the work herein described. Application is hereby This application is made in compliance with County Ordinance 549.. JOB ADDRESS AaLOTION---.. ----------------------------=-------------------------------••-- J -� -----Pho.ne Owner s Name------ ---- -------•-----------..._..----'--------•-------... ------------------------------- . •-------•Address---------------_ :- Phone------. •-------- ----------•----- Contractor's Name------------------ .. . Installation will serve. Residence [J? Apartment;l-louse*❑ �Cornmercial,❑Trailer Courtx.❑�Motel- Other [ - 'kll i t Number of living units: ---�-- Number of bedrooms .:Number of baths _.l_-_.Lot.size ,.r ��• Water Supply: Public system Community system ❑ Private ❑ Depth to Wafter Table .''d_ tt Character of soil to a depth of 3 feet: Sand E] r Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe 2 ardpan ❑ Previous Application Made: (If yes,date--------------------) No K New Construction: Yes El No 93' FHA/VA: Y s ' No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: `' f (No septic tank or cesspool permitted if' publicsewer is available within 200 feed) w+ y _ _ stance from foundat"ion-------------- -`--.Material;_4-,---------------•--------------- P 4 --- �. --- Ca aci nce from .k � � ----------Li wd de th---=::_-=-- - � S�tic Tank; blot of coin artmentst well--------:- --• �Ze-----•----------------- q P ,� P tY--..., ---'---- �-� Disposal Neld: Distance from'nearest well__-: ' '----Distance from foundation--------------_---.Distance to nearest lot line---------------_. k Number of lines-----------�-s-----'--------------Length of each line----- Q -----------Width of trench-A!,. ---- Type of filter material__ -.� _- Depth of filter material----� ��--------Total length__ZMF-'-.-•-------- ------- t r Seepage Pit: Distance to nearest-well----_-�"� _-----Distance from foundaf on___..��=?!tDistance to nearest lot line--._._------•---_ Number of pits-----.-:-Z----------Lining material--- /Q -----Size: Diameter _y_1.-.--------Depth--. s �..--••-------- Distance from nearest well----------------Distance from foundation---._..-__-_---.---.Lining material---.---:----._.-__---._.---:--_.--- 1 :.. . � Capacity ` ❑ - �-----------Depth---------------------•------------ ---------:-----Liquid Capacity------••---------------•---ga s. +� Priv Distance from nearest well 1 e - , _______-_:-Distance from nearest building------------------------------------------ Privy: -------------------r--__.--------------- y: - - ' ❑ Distance to ------------------ nearest lot line--------------------------------------------------------.~ ----~---------�•---------••-------------••----------------' ---------------- Remodeling I Remodeling and/or repairing (describe):._..----_- E --- --- ---• ------------ ---------- -- i ---------------------------------------------------- -.---------- --------- e % ti ------------ - ------ ------ -- - --•---------------------------------------------------------------" ------- ------------- it 1 --- 0 I hereby certify that"I have prepared this'application and that the work will be done'in accordance with San Joaquin County .= 1 ordinances, State la S, and rules and regulations of the San Joaquin Local Health District. 1 - ontract l [Signed(------- -- - ---- -- -------------- - -------- --'- - - --• - -----------------------------Title_ - -'-'----'----' ' (Plot plan, showing size of lot, location.of-sy in.relationato wells, buildings, etc.,.can-be placed on reverse side). FOR DEPARTMENT USE ONLY i ------ DATE--------�� _1416-10------------------------ APPLICATION ACCEPTED BY - -----------------;- REVIEWED BY-----------------------------------------------------------------=-------------------------------------------- DAT E------------------------ tBUILDING PERMIT ISSUED----------------........ ----------------------------------- DATE------------------------------------------------------------ 3 Alterations and/or recommendations:-_:_ _ .. ---------------••------•----•=------•----------------....---------------------------- 9 •------•-------------------------•-----•------ --------•--------------------------------- 1 ------ -------------------------------------------------------- ------------------------------- FINAL [NSPECTION BY:.-------- =---- -- Date-------- ��-� SAN JOAQUIN LOCA HEALTH DISTRICT it -130 South American Street 300 WestOak Street _ t, `- 124 Sy�mgre Street 205 West 9th Street t stockton,California Lodi,California Manteca,California Tracy,California ` ES-9 REVIBEb 8-59 F.A.Co.8M 6•00 '