20504 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: --------------------------------------------------------- ----------- ----------------- ------------ APPLICATION FOR SANITATION PERMIT Permit No, - ------------------------------------------- (Complete in Duplicate) -. . ----.--- This Permit Expires 1 Year From Date Issued jj Date Issued - � � 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 compliancewithCounty Ordinance No. 549. JOB ADDRESS __--l�-.etAYe__he'f�.-- - -.�- -Q / !4Q,5- � ✓l5 r Owner's Name------- ------------------------ -------------------------------------- Phone----..--.... ..----•-•--- '5�,r'��'/� 'ls_f ---•- --------D----t-� C r'p -----------------•-- -----I...-�.-.Address �. Zt,. ----- . CGau_l-// ------- Contractor's Contractor's Name----- lY .- -•-•----•--- PhonaZ,6.96Q f � Installation --- - will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __ --- Number of bedrooms4_,.3Number of baths f.l"' Lot size _--iZ ------ -.X___ Qe --------------- Water Supply: Public system ❑ Community system ❑ Private X Depth to Water Table _? ft.~ �t# Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Lraam❑ Clay,®'Adobe ❑ Hardpan RL Previous Application Made: (If yes,date----------------_--) No X New Construction: Yes K No [) FHA/VA: Yes No ❑ lr TYPE OF INSTALLATION AND SPECIFICATIONS: s (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well-� -----r-Distance from foundation--/ .-1-___ Material.- 25 No. of compartments.......___!Y__--Size_-- r �-�---------Liquid depth---��'�__�--- - Capac�ty,/�.�f Disposal Field: Distance from nearest well__-45_ ._Distance from foundation-lQ.�--___.Distance to nearest lot line---------r_-_- Number of lines___-x_______.____ ___._.__._Length of each line_- S^!�d_.Width of trench.---g: �� _______________ Type of filter material__►S.,—e/..__Depth of filter material__/0_____._-__`fotal length------ ;4:90--!------------------- � f Seepage Pit: Distance to nearest well.-/6_4_.`!.__Distance fr m foundation-- d_______..Distance to nearest lot line--S__/_____ f�ANumber of its...._- --. Linin material_�'�� _._..Size: Diameter---':- _--------.....Depth----oe-4-S_------------------- ; Cesspool: Distance from nearest well-----------------Distance from foundation.___- ._ - Lining material--------------------------------- ❑ Size: Diameter------------------ - - ---- - -------Depth--------------------- ----------------------------Liquid Capa ciky----------------------------galSL Priv Distance from nearest well-_----------__ i t� Y= ----- -- ---------Distance from ,nearest building -,�------------------------------ F1 ----------------- --- ---- -- a ❑ Distance to nearest lot line----------------------------------------------------------------------- Remodeling and/or repairing (describe) / U`11 K - yi �-- _ 114W t ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ---------------------------------------------------------------------------------------------------------- _____.__--- ------.--.--_------------_._-.-__---.-.--____________--_--__t___---..______-.-- .__..-_-- I hereby certify that I have prepared this application an tha+ +he w'6&will be done in accordance with San Joaquin County ordinances, State laws' nd rules and regulations of he Spfi Joaquin Local Healfh.District. + 2,*A$. - - ' ..1 (Signed) ..- ---f--'-- �� '=-- � ��- ------------ - w r and/or Contractor) 41 B f '-\ `' Tit Plot lan, showin size o ot, location of stion to wells, buildings, etc., can be 'F i ( p g y g , placed on reverse side). � FOR DEPARTMENT USE ONLY I APPLICATION ACCEPTED BY - - -- -- ---------------------------------------------- -------- DATE ?"` -------- - REVIEWEDBY--------------------------------------------- --------------------- -------- --------- ------------------------------------- DATE---------------------------------------- ----------------- , BUILDINGPERMIT ISSUED---------------------------------- ------- ----------------------------------------------------------- DATE--------------------- ----- Alterations and/or recommendations------------------------------------ '- -------------•---------------------------------------•--------------------------------------------------------- ---- --------- --------------- -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•---------- ---------- ----- -----•----- -----------------------------------------•- ------------------------- ' ------------------ -- ------- ---- -- ------- --------•---------- ------------------------- i --------------------------------------- --------------- -------- --- ----------•------------- ----------------------- R Date- ' i `-- ��lo FINAL INSPECTION BY:----/ am - --------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street i Stockton,California Lodi, California Manteca,California Tracy,California