17461 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: , r / .e - ---------------------- lON FOR SANITATION PERMIT Permit No. .. r�-•- f >�-------------------------- APPLICATION � (Complete in.Duplicate) -Date Issued .__S _��--•�Y This Permit Ex ire s 1 Year From Dat Issued - p p, lication is hereby made to the San Joaquin Local 0 denafh District for a Permit to construct and insial4 the work herein describe . This application is e in co with county4f ' ' - -le----- ----- JOB ADDRESS Phone--------------------•---------- i Owners Name----.__/2 ,/• s Address-_------• --- ---- �/ - ------------------------------- t Phone Contractor's Name.... .__ -= t- ---- ------- f Motel [] Other ❑Installation will serve: Residence partt House ❑ Commercial ❑ Trailer Cou-t ❑ / I I Number of living units:.__.... er of bedrooms. Number of baths _ --- Lot size 7 Depth to Water Table .__-- _ ft. Water Supply: Public}system Community system ❑ Private ❑ Sand Loam ❑ Clay Loam 'ID Clay ❑ Adobe ardpa/n ❑ Character of soil to a depth of 3 feet: Sand ❑ ,Gravel ❑ FHA/VA: Yes /No ❑ I Previous Application Made: (If yes,date._.--------""..-----y No New Construction: Yes �j�a ❑ I TYPE] (No septic ept Lta k o Ge AND permitted ifOpublic-sev�er is available within 200 feet.] ' ( P p `• r stance 1 ` ---- --•--. romfoundation.._ Q Septi Distance from nearest well."_ D I No. of compartmenfs------1'3-.-------- Size._. _ . .i/ Liquid depth - ..-Capacity__ . nth of each line___- - : Width of trench:-_; -- -ne--�--•-------• 0" Dispa'sal geld: Distance from nearekt well.-.ire=.- -Distgance from foundation..._ ------_-Qistance to nearest lo�li�� Number of lines.______-- j�- Total len th.... ..�7 Type of filter material__._ .1t�r l--Depth of filter materla4....- -'-- i g W t 1 .�---_ DistanceA- om foundation....,ll/_.•_-----_.D��c ce to nearest lot li e.-b=-_-------- to + . +( I See a it' --- Number of pearest�well_.--;---Lining material.- --.-C}�_k�--•-Size: Qiameter_��------------- p '� Cesspoo4: Distance from ne�aarr``e--s••tt well-----------------Distance from foundation.---._------ .Lining material .___-......_._.---- gals. Depth = -----:--Liquid Capacity-------------------------- Size: DiameteEj r-----=------------- ------- Distance from nearest building----------------------------------------- Privy: ` Distance from nearest well-------- ----#--- -------------------------------- ..-. Distance to nearest of I)c. -------------------------- ---------------- _ �" -------- ---------------------- - ------ ------------------------- ---- g (describe):-. � k- Remodeling and/or repairing �. - , - ... .......... 1 --------------------- .....__...4 ""..._.--."..._-..."..._-._... --- Y :..__.•........................................................' --'___.........___....... -_:-..._____.__...._.._......._...._.._..__.__ % _ _ ----------------------- --------------------------- - -.--.---..._-. i .._......,. _ _ ------- --------------------------------------------------------------------- ---•--------- Mork will be done in accordance with San Joaquin County a f hereby certify that I have prepared this application and that the " ordinances, St laws, and rule and regulations of the San Joaquin Local Health District. _-------------------------(Owner and/or Contractor) {,`'(Signed)---------- -- -- # r - A I Ges-r ------- ------------------}io wells, bull -----•-(Title)---- '- '' ------ --- l 1 By:-------_-- --•------------ -- --- ------ J - --- ------------------ tan, showing size o 0 ocation of system in reka dings,.etc.,'can be placed on reverse side]. �[rl � i FOR DEPARTMENT USE ONLY i ei I DATE---------- — ------- �APPLICATION ACCEPTED B! { ----------- REVIEWEDBY---- -------------- --------------------------- ------i--------- ------------------ DATE BUILDINGPERMIT ISSUED------- ----: -------- - - - -------••--------------------------- ------------ -------- -- ----•------ I Alterations and/ recommend do s:. == C - - ++/r�� - - 7 4..._ ._---------------------------------------- --------------------------- .-._...._-....----------------- ---------- .._-._.- -.... . -�-� -------------- --------------------------------- --------r------ ------------------ _ r :. �---� --- i Date"...... .7. - FINAL INSPECTION BY:---- �'r ----------------------------- SAN -------- -- ---- SAN JOAQUIN LOCAL HEALTH DISTRICT 1 bol E.Haselton Ave. 300 West Oak Street ,+ _ 124 sycamore Street 205 West 9+h Street Lodi,California Manteca,California Tracy,California Stockton,California I Eg 9 REVIVED 6-58 9M 3-'63 F'R'C R.