6309 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT : Permit No. ___ .3 (Complefe in Duplicate) S� Dale Iss-a-d ______ ®�SS Applica+ion 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 Ordinance No. 549. JOB ADDRESS AND LOCATION•-____.6 5..So,---CQol dgep-._StQmkt©n--_-_--_--.--- Owner's Name. Ly 1p- XC.__Donald Phone_HO 2763.7 -- Address-----------------••---------- Same Contractor's Name------------------ -------"------Parrish---T e-a------•-- ----- ------ Phone-----H0_...6960T------ - ---------------------------------- Installation will serve: Residence XX Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel-❑ Other ❑ Number of living units: ---1- Number of bedrooms ----3__ Number of baths __I_ Lot size ------ _ _�___. 1 75 X59.------ ---- Water Supply: Public system$] Community system [) Private ❑ Depth to Water Table __-5Q ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ® Hardpan ❑ Previous Application Made: Yes ❑ NoXX New Construction: Yes ❑ No ❑ Supplementary drainage, TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well---------------.-Distance from foundation__.-----------------Material ___.____.____.____-_ l isting No. of compartments------------- ------------Size--------------------------------Liquid depth------------ ------------:Capacity------------------------ Disposal Field: Distance from nearest well.................Distance from foundation___-________--.._..Distance to nearest lot line__-_____._-_____- lUisting Number of lines-----------------------------------Length of each line-.__-----------------------"-.Width of trench Type of filter material-------------------------Depth of filter material-----------------------Total length__--______-______--._ ------------------•- Seepage Pit: Distance to nearest well---- C2ne----._-_Distance from foundation__32 ----------Distance to nearest lot line-1�-t.______ I Number of pits.__ --------........Lining mate rial_____$rick--.Size: Diameter----33`x_----- ..Dept h--------_. T Cesspool: Distance from nearest well_________________Distance from foundation-----.------------- Lining material---------------------- ❑ Size: Diameter Depth_ Liquid CapacitY- - _--gals. Privy: Distance from nearest well-------------------------------------------------Distance from nearest buildin ❑ Distance to nearest lot line---------- ------------- 9 Remodeling and/or repairing (describe)--------------------------------------- -- -:--_- --------•-----------------------------•------"--------------------------------------------------------------------------_-------------------- -------• --------•-----•----:-------------------------- --------- 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 f f the San Joaquin L cal Health District. 5i ned { '9 )--------------------------P.ARRNIL.I *-----------`•:-- (Q� Contractor Plot Ian, showing size o-- lot location of system n relation__ , ------------"""--(Title).Eztjg1atAr------------------------------------- -Y' - ( P 9 y fls, bui ngs, etc., can be placed on reverse side). FOR DEPARTMENT SE ONLY APPLICATION ACCEPTED BY-------------'------ -_----- DAT - ------------------ REVIEWE D BY ------ -- ---- ---------- -- DATE---- BUILDING PERMIT ISSUED----------------- -- - ------- T- ------------- DATE----------- - -- ---------------- Alterations and/or recommendations:__-_____________ 4--- --- -- ------------- S-'•----------•------------------•------- - - ---------- ----- ---------•------------- ------------------------------------------------- --------------- - -- ---------------------- FINAL INSPECTION BY: 5--------------------------------------- Date----.-. J. SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California �s-9-2M [45446 ATW❑pb 1254 � �- r .