21913 - Laserfiche WebLink

Home Browse Search

„,r FOR OFFICE USE: - --- ---_+--------------- ------------------------ - - 1.. --.----- .___..__._.---____---------------__ _____ APPLICATION FOR SANITATION P1=RMIT Permit No. f � ----------- -=----------- ------ --------- (Complefe•.in Duplicate) This Permit Expires 1 Year From Date Issued Date Issued .-w-:--X__ 7 Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. f This application is made in compliance with County Ordinance No. 549. I JOB ADDRESS AND LOCATION_.-- ----25-75 .___. }G Lnf ; SC 1--}LQ� I Owner's Name---------- --------- Q :fS�._t_ Phone Address----------- 2 J� f� 1 --------•• EC_# -------- -A- SC k/V Contractor's Name____ _d.]-I-�______/501_/�fS_- t-v /� f ?. - Phone-- ------------�--- - - -- ------ - -�- h - Installation will serve: Residencer2!�Apartment House-E]. Commercial ❑ Trailer Court ❑ Motel 0 Other ❑ Number of living units: . Number`of bedrooms -: ” Number of baths_- -- Lot size __._ __. ..2 �1 ----------- Water Supply: Public system ❑ ComMunity system''Ei Priv l e Depth to Water Table 15_eft Character of soil to a depth of 3 feet Sand ❑ Gravel E]- Sandy Loam ❑ Clay Loam Clay ElAdobe p Hardpan Previous Application,Made: (If yes,date_----.'._. `.__` ) No� 2r "No Construction: Yes 2o ElFHA/VA: Yes [r"No TYPE O INSTALLATION AND SPECIFICATIONS: E]-t-s/ :I : t {No sept tank or cesspool permitted if public sewer is available within 200 feet.} ; .Septic Tan ---.6=�,.r,_,.- .��.�_ _ _ _ �Distance=from�nearest well------" � �?`T- T 4- 'F - -� 4 }. w.. ulst�ance from foundation__.__ --- - Mater i . C -T-f� No. of compartments_._-..__ . ....__Size�/X E - x �a Dis / .q Pdepth_ 5. Irz-....-._ .. .Capacity,---� 00. + _ Li ur / p` sal Field: ' ..'Distance from nearest well:. G7-- Distance(froml_I_ fou ion. _. ' "F `�~ I «._..__._.Distance to nearest lot line_--____..____--_. to Number of lines.----- ------ -- -- ----Length of. fte - --------- - idth of trench--- -- ------ �-� Type of�,filter materialQ_C _--Depth ofRfilfer material___:`/�-----' � g tA -dotal len th___ - - ' 1 p g` �P t Distance to nearest welL_.10-P-------Distance from foundation___// ` /� .-._ ____. Distance to nearest lot line_____`�'�_-_ I� ee a e . . Numb'er of its_ - --Z_._._. r' P ----- Lining materia!_-RQ_c�.--- Size: piameter_�-�-��- Depth----- ..f'-�-.-._ (r Cesspool 4 Distance from•nearest well_________________Distance from foundation.-_ ------- - Lining material__.---- _ t ❑ Size:-Diameter. .. :_..-- ----------------Dept h-------- --- ----- ----- - - ---.Liquid Capacity- --- -----gals. Privy: ,,,<Distance from nearest well_____---------_______-_-----------._...-_______Distance from nearest building__.__..______._ • 1f7istance to nearest lot line _..._.__._._._ RemodelingRand/or .repairing (describe)--------- -------._.. ------------- �d ----•---------------------- ----------------------------- i ------ --- ----------------------•--------------------------------------------------- ---------- ------------------------------------ I hereby certify that I have prepared this application.and that the work will be done in accordance with San Joaquin County ordinances, State I s, and rules acidyjulafli., ns ofthe San Joaquin Local Health District. (Signed)- --- -- ---- ------------ --------------------------------------- t-.(Owner'and/or Contractor) By---------- -------- ' -----------------------------------(Title)--------- --------- - -... . T* —(Plot plan;showing-size-of-lot,location-of--system-in-relation-to-wells-buildings;`etc:; can-be placed-onTreverse side): FOIL DEPART ENT USE ONLY t APPLICATION ACCEPTED DATE � �- - 3 - --- ------------------ -- REVIEWED BY- --�- ---------�-� ---------- ---- ---�- - ._-�--- ------ --- -------------- ----------- --------------------------- DATE-- - - ----------------------------- -----�-�----�----•- - -- - BUILDING PERMIT ISSUED--------.-.----------- - --- -- - - -------------------- - - ------------- --- ------•------ -------. . DATE.---------------------------------- --------------------- Alterations and/or reco mendations:_----_..__....... ... ... .......... ..... ....... .. -------- ------------------------------------ --- ------•-- •-------- !� <Y��1rt/6jc -t ' Vis. Zx ' - LP--. b- - `T74uK_.-._lYom-...__L�Si`R��D-----Pao, t�+- AsK�..._.'�'-cv 1 .`° LEracH -iNs_-.-. -f.1<_ _.. --- FINAL INSPEC-T.LON BY:..._, Date----- /d_ �CI' �� -------- - ------ SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E."Hazelton Ave. '300 West Oak Street 124 sycamore Street 20.5 West 9th Street i'','= Stockton,California Lodi, California Manteca,California Tracy,California E.H.92fd E•67 Vanguard Press �;