68-243 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: j -_ :..- APPLICATION I"OR SANITATION PERMIT Parmit INS_". .:...��. ----------------------= - --------- (Complete-in Duplicate) 46 T '.._`.._ ` — 'This Permit Expires 1 Year From Date Issued Date Issued r Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordin"o. 549. JOB ADDRESS AND_-- ••�•L CATI N-..---- ----� ''------------- Owner's Name--------- -_-- j Address •- -- ----- .••-------- --------------- -------------------•------- Contractor's Name i.l. : Phone----- �� , iP j Installation will serve: esidence ' Apartment House ❑ Commercial ❑ Trailer Court [:,]eel, ❑ Other ❑ Number of living units: _ . Number of bedrooms,Q/Number �baths.-_I____ Lot size __ _1 ..� �______________________ Water Supply: Public s stem Community system /P�vaf De th to Water Table �7 PP Y• Y Y Y ❑ P � --, Character of soil to a depth of 3 feet- Sand ❑ Gravel ❑ Sandy Loam❑ Clay Loam El Clay ElAdobeAN Har pan ❑ Previous Application Made: [If yes,date................... ) No &r New Construction: Yes E] NoP5--F-HA/VA: Yes ❑ to ' TYPE OF INSTALLATION AND SPECIFICATIONS: ) ' ' J. (No septic tank or cesspool permitted if public sewer is available within .200 feet.) ce•;from faun ation_.f 0r'_.Material ___- - _.._ ---. Septic Tank: Not of eompartments e/�. __ `. zee. _ �_Liquid depth-.S._�_rr Capacity_/Ar, t ' Disposal Field: Distance from nearest wefAX=�..Distance from foundatio 19 Distance to nearest lot line - Number of lines __C -__...-- -_ Length of each line- -- �...............Width of trench.�-_4___-. Type of filter material] __ __ _ ___ _____Depth of filter material_.:/_&V y_._..Total length---.---.Z&O-------_---_-- Seepage Pit: Distance to nearest we'll---------------------Distance fromjoundatiori__`�__--________.Distance to nearest lot line,_.._.__-_.;_____ [] Number 'of Arts-I -------- -------Lining materi�l- .--- P. Size Diameter----_---------_--------Depth.------------------------------- Cesspool: Dstanca f3om noarest'weil ........ 5. Distance from foundation `.`% ___.___ Lining materiaL-----------------------------------_ ❑ Size: Diameter- -- ----------- -- ---- ' -------------- ---------------- ,-- gals. Privy: Distance fromi.nearest well:4.............. � I___ _._._._.._:_,Di0ancehfrom nearest.building------------------------------------------- ❑ - --------------------------------------------------- ---' Distance to nearest'Ibt + " "' �' ` I ti ' ' •• - }" -------- A Remodeling and/or repairing (describe):;---- ------ �� i ------ �+ ----------- -------- r -- e Sc ...-..-- ------------- - _ __ .- r I hereby certify that l ave re ared this a licatiori-.and that the- r will be done in accordance with y y p pa` pp San Joaquin County ordinances, State laws, a ules and-ii:gulations of the San Joaquin 'C'' I Health District. t (Signed) = --------------------- ------ ----(Owner and/or Contractor). r BY:------------------------------- -- ---- ---- -- - ---- . - - - ----------{Title)------/A.—Le-'r.-_ �_..}_: (Piot plan, showing size of lot, location of system in relation, wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY---147//— 1-r DATE.- �!!-e -------------------- REVIEWEDBY----------------------------------- - -- - -------------- -------------------------------------------------- DATE----------------- ------------------------- BUILDING PERMIT ISSUED-------- ---- ---------------------- ------------------------- DATE----- --------------------- ------- -- ------ Alteratipgsjnd or recommendations:-": —---- -------.--------------------------------------------------------------------------------------------- !'- - ---' ---- --- ----- ----- ------------------------------------- On - -6n -- - -- ----------------------------------------------- --- ---------------------- ------ -- ---_----------------- ------ i ---------------------------------- -- -- -------- ----- ---- - --- --- -_ ... - ----------------- ---- FINAL INSPECTION BY:------ .--------------- ------- ------- Date------- ,x..-- - . ------. SAN JOAQUIN LOCAL HEALT-H-':DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street k24 Sycamore'"St4et 205 West 41h Street Stockton,California Lodi, California. , Manteca,Califdrfid Tracy,California E.H.9.4M 1-67 VangUord Press I" .