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4200/4300 - Liquid Waste/Water Well Permits
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14455
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Entry Properties
Last modified
11/26/2018 2:38:31 AM
Creation date
12/4/2017 9:06:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
14455
STREET_NAME
DANA
STREET_TYPE
ST
RECEIVED_DATE
07/06/1962
P_LOCATION
CLARENCE DALLARD
Supplemental fields
FilePath
\MIGRATIONS\D\DANA\0\14455.PDF
QuestysFileName
14455
QuestysRecordID
1709280
QuestysRecordType
12
Tags
EHD - Public
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--''U--' <br /> APPLICATION FOR SANITATION PERMIT Permit No <br /> ^ <br /> (Complete in D"r"^='°) 0mta Issued 21,el'u~--- <br /> App||ueMo" is ken,6* mu6a to the Sun Joaquin Local HomNh District for u permit to construct and install the work herein 6eam,Imed. <br /> This application is made jin complian4cewit County Ordinance No. 549 <br /> JOI ADDRESS ANDff ATION- —------------- <br /> � <br /> -------------------------------------------------------- <br /> Address--------------- 1 <br /> he 0 <br /> Installation will serve: Residence Er--Apartment House'[3 Commercial- E] J�r�iler Court 0 Motel 0 Of r <br /> Number of living units: Z.. Number of bedrooms Number of baths _/... Lot size .............................. <br /> Sy ff. <br /> Water Supply: Public stem axcommun�ify system 0 Private 0 Depth TO Wafer Table -44� <br /> Character of soil to a depth of 3 feet: Sand O Gravel U Sandy mum U Clay mom [I Clay C] Adobe 8 ga-rdpa" u <br /> Previous Application Made: (If yes'dota-------------------- No Z?,-New Construction: Yes 83^~-Wo [] FHA/VA. YeeNo9�--- <br /> TYP5OFINSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is i| blwithin 200fme+J / <br /> Septic Tank: u/m� ���_��_��".""" <br />\ <br /> Disposal : Distance from nearest <br /> Number of |i �- Length � h � � o � * cn <br /> � � --_.-.---Tvpo c� filter maferiui+ - - <br /> � ^ <br /> Seepage +' Distance to nearest � __� �- to nn�,=, / ^P__/ <br /> NumbmrofpKa-~7�-_-Lining mofori 4; ---Size: Diameter ------Depth-�xt;�.-----'-- <br /> Cesspool: Disfonco.from nearest well .---_-Distance from foundation----- --------------Lining mn+arioL--.---__--_- <br /> [] Size: D|am" efec--___------Deoth----------------------------------------------------Liquid Capacity...............-------------gals. <br /> . _ - <br /> Privy: Distance from neor�lfwell--------------- ---------------------------------Distance from nearest building------------------------'----'- <br /> �] Dktunce to nomne,+Jo+ |i . -'� <br /> _____---_-''-___- <br /> te <br /> Remo6o�g and/or repairing \:---'`� .-_ <br /> __-.______---__--.__.-__.._.__.___'-_.''----___'''__--__.'-''_'-'---''-_.'--'-_---_--.-- <br /> '---'-------'--�--------'--''-----'--'—'---'---------'-------'--''--'-'-------- <br />� ------------------------------------------------------ <br /> I hereby certify that I have <br /> � <br /> prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances,- State laws,_ _- rulespnd regulations of the San Joaquin Local Health District. . <br />� <br /> (Plot plan, showing size o* lot, location of system in - tion to wells, bui_ldirtgs,_efc.,,can be placed on reverse side). <br /> ' ~^~ ~~ ~~'^^~`' ~~^ ^^'`~' <br /> Ir <br /> iAPPLICATION ACCEPTED~DY.__.--__-_�--.__--__. ~rft.�' '' DATE--. L.�.� .�� -_--' <br /> '''_-'___-'''_-'----_--'REY|ENED OY'--'------''--'-'--.-'''--'--'''-''---'---_ �. --'' u*/� <br /> BUILDING PERMIT ISSUED ' ' ' ' -- ' DATE-' ' ' '' <br /> ons <br /> recommen <br /> !| <br /> ------------------------------ -''''-'-''--'---'-'''-''_--'''-''-''-'''--_-'''- -------------------------------------------------------------------- --------- <br /> - <br /> _ <br /> -------------------------------- _- ----------- ''-''-''--'-''-'''-''�-_''-'''-_'''--'----------------------------- '' --------------------------------------- <br /> ------------------------------- -''—'''--'''---'-'-''''-''--''''''---''----''''-'----'-''---''—''-'-''-' <br /> RNAL INSPECTION BY: / Date --.* <br /> T�r—� . SOP <br /> SAN JO�AQQO|N LOCAL HEALTH DISTRICT <br /> 1a0South American Street 300West Oak Street 12*Sycamore Street 20aWest 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> cspREVISED a-onzw 5-62 ATLAS <br />
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