17044 - Laserfiche WebLink

Home Browse Search

- __ FOR'OI=NGE USE: ------------------ Permit No. . .. - � APPLICATION FOR SANITATION PERMIT - (Complete in Duplicate) Date Issued ----------- ------------ ... -- ---------I--------------------- This Permit Expires 1 Year From Date Issue Application is hereby made to the San Joaquin Local Health District for a err' it,to`tonstruct and install=the..work herein_�escribed. This application is made in compliance with County Ordinance No. 549. p � ��` 3 . : 1 Ati jC}U V i` - •---.D Q I ----------------- JOB ADDRI=SS AND OCATION:-_--_--_ _ --- 1 _ --�. - "..,""` .,�.�'.. e �.;.. . ... . ,. Phone.- a " Owner s'Name__.____.__- -' ------- Address _ �_.�----- ----- � -A------------- �A1T��R------------------ - Contractor's Name__ A�1T>� -----� PTLC--•--SE �L_lc -------------------------------------- Phone.. Installation will serve: ' Residence Kr Apartment House 171 Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: J____. Number of bedrooms __3._ Number of baths _ Lot size ____ACP1X-- ----------------- Water Supply: Public system F1 Community system ❑ Private Depth to Water Table _i_ ft. Character of soil +o a depth of 3 feet Sand-dGravel-2-=Sandy-Loam ❑ Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: (If yes,da e._.__-._ ) No [g�New Construction. Yes �No ❑ FHA/VA: Yes ❑ No�- •� --TYPE-OF INSTALLATION AND SPECIFICATIONS: No septic tank or cesspool perrnit+ed if public.sewer&available within 200 feet.l L� Septic Tank: Distance from nearest -w-eh---- :"_ td.is#ante from foundation---------- ------ Material---_-__-.-_--..--_-_.--_-.------__.----..----. 1 .. a. y b� X j-'rT '/fG- No. of compartments---------- ---------------Size--- -----_--------- Liquid depth - - Capacity la__---_.-.Distance to nearest lot line--_ Disposal Field: Distance from nearest well-__. ____-Distance from foundation____ - width of trench-_..7�3-.",14 2-f--___J eX}g9Tr 0"(C— Number of lines----------- -------------------- Length of each line------' .--- /� �}- APP' Type of filter material---F0j 1;6,----Depth'of filter material-_-'LG_�_' .iT�tal length__..___._,.'/_��------------:---------- Seepage Pit: . Distance to nearest well_ ______________ __Distance from foundation---------- :__._. DiOifi `ce:.to nearest lot line- .-_------- ------- _ ---Lining material-----------------------Size: Diameter-- -------------- -----.Depth---------- ---------------------- ❑ Number of pits Cesspool: Distance from nearest well--------------- Distance from foundation..._-- -------- material--------- ----------------- - ❑ Size: Diameter----------------- --------Depth A Liquid Capacity 9 ft Distance from nearest buildin Privy:' Distance from nearest',well--------------------------------------------- g ❑ Distance to neares'f,lot line-------------------- N------------------------_4------ Sr ti It A Remodeling.and/or repairing (describe):______-_---,._. -------------- --- -------- --------------------------------------------------------------------------------- ---------------------------------------- ` --- = - ---- . rte ------ ------ - ------ ----------------•-----------------------•-----•----------------------•----- ----------- ------------ - ------------------------- --------- ----------------------- =--------- :-` ------------------------------------------------------------------------------------------- - I hereby c fy that I have prepared this application and.tha+ the wor0will_be done in accordance.with San Joaquin County ordinances, St Jaw.-f and rules nd egulations of the Sart Joaquin'ocal Health District. t a. G _-f_-µ _- ----___ ---- _---__._.-.-(Owner and/or Conttr actorl -------------- --------------~--�------ - -- ------ - (Title)------------------------------------------- - --- - (Plot plan, showing size of lot, location of system in relation to well builkngs, etc., can be placed on reverse side). . y FOR DEPARTMENT USEIONLY , - I DATE------- APPLICATION ACCEPTED BY T�_ -�� - ------------- _- tREVIEWED BY---A ---------------•---- --------- - ""„'"------------------------------- DATE I _:------------- DATE------------------------------------------------ ---------- BUILDING - BUILDING PERMIT ISSUEDJ----------------------------- - x,,, ,. .---------- i Alterations and/or recommendations------------------------------•--------------------- F ---------------------- ----------------------- --------------- _ ______________]---- _---.-.-._---__------.---- -----•---_------__----_--------- !*-=-------_-_•........................•--. -' - _____.______•__._..... ______________________ --- ._. -------------------- -__._ ._ ----------- - ------------------------- -------------------------- _-___--- -. ---- - _ ----._-----....___._.._...__.__..._.____._.__..._____.._____....__.___..._ _____-.____.-------- _ ----- -- - - - ------ Date---- --- ------�-------,---- -- ---- - -- --------- FINAL INSPECTIO - -- - SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.HaTalton Ave. 300 West Oak Serest 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California f E5 4 REVIseD B-59 3M 3-'63 F,P.CC.