76-346 - Laserfiche WebLink

Home Browse Search

FOR-OFFICE-USE. . - ....: - N r ........... APPLICATIOPOR:SANITATION PERMIT 7� ,3 (Complete ins:Trlplicatej Permit No. s' ............................................ r, ........_....._.__... ............................... This•PermitExpires 1 Year From Dot*issued Date Issued __�.:�:q__ 4 Application is hereby made to the Son'Joaquin LocalA.mealth District for a permit to construct and Install the work herein ) described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: JOB ADDRESS/LOCATION ............... ]�1 2 6...I)e1ana_...•------•--..:- ...CENSUS TRACT. Owner's Name Mr. Litchenberg ... .................. . ........................:.... ..... .......Phone X416 ............... .:.............. ' Address � Delano`= Stockton ------------- C€ . Contractor's Name ---------- --2 1 RD-to••-ii©at-er• S.e�, .............License# ...... 7153:9.. Phone 41�'S Installation'will serve: '° ............ . Residence®Apartment House C) Commercial JiTraller Court Motel Q Other...... ......... ... ............. .... Number of living utli s:..._.._ Number of bedrooms 2__-:-.Garbage Grinder Yes Lot Size 1 acre 2114s . Water Su ----••-•-•-- ..--•--•........... ....................... PPIY: Public 5 ern and name ------Calf.---W�, er __.,.and private .- ...... - ............... .._._..._......_...Private [] Character of soil to a depth of 3 feet: Sand t] Slit)] Clay ❑ PeatQnp es Sandy Loam C) Clay Loam -Hardpan 0 Adobe� Fill Mater€al ....I .... If yes,tYPa............... ............ {Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT j ] SEPTIC TANK iSizex 5 9 liquid Depth _.. .. .. ._.. 12 0 0 2.......... Capacity . Type Pie castMaterialconcrete10No. Comp P tY Compartments Distance.to nearest: Well ___ ___________ i ................:.Foundation ........_.............. Prop. Line LEACHING LINE j No. of Lines ----1_--••------__-... Length of each line........ 0.Q.!.---•-..... Total Length ....1.0Q.f............... •D' Box �o_.-..__ Type filter Material ..t.86 __..-.:Depth Filter Material ....18.'x, s .. ........................... . . 0r Distance to nearest Well 5 Foundation 10 5 r t 2 10 ; , x� .:-.:.... perry Lina SEEPAGE piTs IE.r 1' ...._ v Property ............... } 2 Deiath -------------------- Dictrneter _,..---•-----.:_ Number ' ' � / _...------•---•-----�--.... Rock filled Yes (� [�Q Water Table Depth ! l0�Y ..................Rock Size Distance to nearest. well 50-1........................... r 5 t O Foundation � ^1 Prop. Line t REPAIR/ADDITION Prev. Sanitation Permit # # .................................••-----••-- Date --•-•-, Septic Tank lSpecify Requirements) .se,m H Disposal Field (Specify Requirements) ...... Owner will fill in old tank and do\1st 10 ' ; ofl sewer hookup •---•--•------••--•-•-••----•••..._......•.....-----••- ---------.. �. ._....... •............. ------------------------•---__--•----------•----._...............---------.. ............................................................. {Draw existing and required addition on reverse ._ rse side). I hereby certify that I have prepared this application and that the work will be scone in accordance with San Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health.,District. Home owner or licen- sed agents signature certifies the following: T "I.certify that in the performance of the work for'which this permit is Issued, I shall not employ any persons in such manner as to become subject to Workman's Compensation laws of California." Signed ------- ----------------------------------- ------------ Owner , BY -- ........ <• � Contractor - •-- -------------------------- itle : (if other than owner) ............ FOR DEPARTMENT USE ONLY APPLI ATION ACCEPTED BY _- ----------------- k.-BUILDING, -- •k.-BUILDING PERMIT ISSUED --•-- ••------------------------------------------------------ ------ ••--- ------ DATE ........ ....... ...... ADDITIONAL C MENTS .._ ----• ---------------- _-.,.........................---------- ............._-DATE ......--........__-...................... -. -----------------• ------------•------ ----- .............._----------- ... _ ..._ .. f- Final inspection by: , --- ' -•------•-•-------- •-••---•------•------• ._-_..---- ..Date -- T -.7- EH 13 2 1-Ei V' S N JOAQUIN LOCAL HEALTH DISTRICT .-W'�_ $/7h 3M