74-125 - Laserfiche WebLink

Home Browse Search

r,. FOR OE.FICE-USE: ---- --- ----------------------- I APPLICATION FORK'SANITATION PERMIT Permit No. - -- -- - ----------•----------- te i �� ----- - (Complen Duplicate) 7 7 ----�--- --------- ------------- - -- -- .. -�'- -----------------_-_.--_--_-_-_-_-----_-_----_-...--- This Permit Expires 1 Year From„pate Issued Date Issued ------••-•------- Application is hereby made to the San Joaquin Local Health District-for a permit to construct and install the work herein descrbed. l This application is made in compliance with County Ordinance No. 549. 220- JOB ADDRESS ALOCATI I-"'-----`-,z4j-�_ �_�e�J-�---- Owner's Name------- - -------��lZ __---------------------------- <7 Phone-� �-��-_L_.1---- Address. * ' cc t=- -�:�� --------------------------•----- �..0 Contractor's Name e& --------- ';Il �- Ins+alla+ion will serve W,Residence Apa�tmentTHouse❑—Commerciaf`❑ Trailer Cour!❑{ lvlote!"❑ " Other ❑ ` � guns !' NuieNumber-of-livi : &droorn :�:N-umber df-baths_�Zzr= Lot size i Water Supply: Public system El Community system [I Private Depth to Water Table . - ft ! Character of soil to a depth of 3 feet- Sand ❑.r. Gravel Sand _Loam Clay Loam Clay Adobe Hardpan Previous Application Made: (If yes date__-i..........-- ... ) No ❑, New Construction: Yes ❑ No'❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: {No septic tank or.cesspool permitted.if,public sewer is available within 200 feet.) Distance from nearest well Distant from founda ' n e fi-(_..Ma#erial � .'� Septic Tank: ---- E� -� ----------------------------------- --------- No. of compartment--------- ---------f'Size_ &__X_06t _Liquid dept .17-P --------Capaci#y./ --p _____-_- Disposal Field: -Distance from nearest well_ - Dista -f_iro��undafion�l�'f___..Distance to nearest lot I•ne__�_fF__�_- _ Number of Irnes.___- __-- --___n-,-� -_-- _Leng o c'Klin, - ---- ' _ Width of #rend- 4�*----- ----------- --- Type of filter material_� y_.�L Depth of filter material-_f -!'� Total length. r____�00_-___-. Cull See a g Pit: y,. iDistmikce t nearest well-lop mDistaince from foundation-�Q- _.Distance to nearest lot line_ -�__ � a rT p g . Size: Diameter.......................Depth-------- ------------ rJ Cesspool: Distance from nearest well __ -------------Distance from foundation----------------#..Lining material------------------------------------- 7 4 F El Size: Diameter- -- --- I 'I Depth # Liquid Capacity --- -- - Privy: g alsr� Distance from nearest welt_-- _...-..__ ---------------_Distance from nearesf building.___-__.___________-____________._.__.-._. ❑ Distance to nearest lot line A-_----__-_ • Remodeling and or re d6n describe -- ------------------------------------ y - - - _ F P b 3 W , ------------------------------------__ _______________________:._--____----_______-_-____________-___________-_-_______ _ ___ i 4 Y ? ---------- ---------------------------"---------'-------------------•----'------_---------------------------------------_---------------------- -----_----------.-_-------------------.--------------------------__...._.- i I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. {Signed) i B : J - c (Owner and/or Contracto r)----- - ' --= --- -------------------- ---------------------- (Plot -----------------(Plat plan, showing size.of lot, location..ofsys m,-.in..rela+ion to wells,.buildings, etc., can;be placed. n reverse side). f` FOR DEPARTMENT USE ONLY q APPLICATION ACCEPTED BY------- F r-- --(��77-------------------------- -------------------- -`-------------- DATE--------- - --- --------------------- REVIEWED BY----- --------------------------- ------- --- --------------- --------------------------------------------------------- DATE----------------------- - fBUILDING PERMIT ISSUED-------- ----- ---------------_---------- --- --------- ------------------------------------- DATE--------------------------------- ------------------------- Alterations ------------- -Alterations and/or recommenda+ions--- ....................... ------------ - --- --- ------------•------ ---- -------------------------- --------- ---------------------------------- ------------------------------- -------------------------- ------- -• ------------------•-------------- --------------••--------•-----------•-•- �. 11--------U , --------•-- -------- ---------•---- --.-.-...._..-- - ---- - FINAL INSPECTION Date------- 1'________2__--2__- ------ ------- SAN JOAQUIN LOCAL HEALTH D&RICT 1601 E.Hazelton Ave. 300 West Oak Street t.) .. _ 124 Sycamore Street 205 West 9th Street i k Stockton,California Lodi; California Manteca,California Tracy,California E.H.9 2M 1-67 Vanguard Press r } 1