Laserfiche WebLink
� <br /> APPLICATION FOR SAAI OA"TION PERMIT Permit No. J <br />/ ----------------------------------------- <br /> _Rate Issued Date Issued <br /> gplication is here6y made to the San Joaquin Local Health District for a permit to construct and install the work herein clescrilbed. <br /> application is made in compliance with County 0�erdd' ance No 549 <br /> Owner's Nu ' <br /> | <br /> | <br /> -- ' <br /> Installation will serve: Residence -�mant House [] - --'—' Phone— <br /> -'''----''--'-' <br /> 0 Other [3 <br /> _ . Comm�rc�/ [] T�U- covf [] kote|Number of living units: / Number of bedrooms jr Number ' <br /> � <br /> Water Supply: Public system E] Community system � � Depth r Z. .......... ' <br /> ' <br /> Watere-r-- ~~ ^'Kharactermfxoil +ma depth of 3feef Sand E] Gravel [] Su."r ��m E] Clay Loam LJ Clay <br /> Adobe <br /> N�~ rrd1pan <br /> Previous Application Made: Ufyes,dote---- <br /> TfpE OP INSTALLATION AND �p£��p3��TJ'��' ) NoQKNew Con``'wctmn: Yes FHAx/A. Yes Ki- Wo [[] <br /> (No septic or ` ] <br /> ' <br /> permitted R public sewer is available within 200 feet.) � <br /> Septic k' Distance from noone,f / -'D| ^�� <br /> nf �, <br /> Disposal Field, Distance from nea�rejrt well---r= _71P------------- <br /> -.-Disfence from foundation-.,--- Pistance to nearest lot <br /> Number of lines-- ---- -ength of each line/------77n- PIVO�Width of trench__.e'_,V <br /> Type of filter material, j!M- epfh of filter material- 4C'4 -------#0-------------- <br /> Seepage Pit: Distance to nearest well------ rom founcipfiol <br /> Number of pifs -----------Distance f _- I---je/V-!�_-Distaoce to nearest lot <br /> ' repairing (describe):---------------- <br /> ------------------------------------------- <br /> --------------------------------- <br /> --------------------------------------- ^r - -- ~ - �---''--''�-------''-' <br /> __._ .. _ -_---'----------'---_-----_-________~______ --�-__----_-_'------_----._-----__.___.--_-_- .__-__.__--..-_..__._--'.-- ' ' ______.____.__-----_---.--- _--'-'----__-----_--__-__.-__-___------__ '------ <br /> �^ <br /> ^ . <br /> ----------------------11-------------------I----------I----------------- <br /> ordinances, State laws, and rules and regulappns of the San Joaquin Local Health District. <br /> /-here6y certify that I have at the work will be done in accordance with San Joaquin County <br /> Ii <br /> � <br /> s. buildings, efc.. can be placed on reverse side). <br /> 'FOR DEPA ENT USE ONLY <br /> APPLICATION ACCEPTED BY-7a7. <br /> REVIEWED BY 7 <br /> 17 <br /> ------------------ <br /> ����'''----'--'-'-'-''' , ���'-'--'''-' <br /> '-'''-'''-----'------------------ --------------''-''-''-''-''-' <br /> FINAL |NSP8CTON BY: <br /> ^��� Duh���~��'- ----_.__.� <br /> SAN oO+a�u/rx �JCAL ��EALTHD|�R�T J7 <br /> /3oSouth American Street x00West Oak Street 124 Sycom"�e�, � <br /> Stockton,California Lodi,California /�"���/�m� '»»yw°*v�o�w <br /> co v ocwaco o'59 rw s,aa »rL^o nan'.«"//fomia <br /> _-2_-4, <br /> � <br />