2610 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. ----_' ` (Complete in Duplicate) ., , - pate Issluued Application is hereby made to the San Joaquin Local Health District for a permit to construct and insfall the work herein described. This application is made in compliance with County Ordinance No: 549. JOB ADDRESS AND LOCATION.. ---------x.638---a4.__-Drake---AVE._--atQCkt_on-------------------------- Owner's Name----------------- Edward Wi1SOA - --------------------- ---------------------- --------------- - --------------- - -- ----- ------- Phone------------------------------------ Address-----------------------------S-ame ------------------------------------------------------------------------------------------------------------------------ Contractor's Name----------D-*---' ..-PARRISH & SCINS_s SNC_.-------------------------------------------------------- Phone---996W------------------ Installation will serve- Residence Z] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: IL---- Number of bedrooms 2----- Number of baths _1____ Lot size _--7-5f-X .001_______________-____--------. ---- i Water Supply: Public system ❑ Community system '❑ Private M Depth to Water Table -------- ft. �kh•, Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe IN Hardpan ❑ Previous Application Made: Yes ❑ No,10 New Construction: Yes ]K] No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool 'permitted if public sewer is available within 200 feet.) • - . ......... ' -. --..;:� � X511 . _ - .. Septic Tank: Distance from nearest well---5Q-- Distance from foundation--- i Material_ 3' k ------------ No. of compartments - p Size tt - !fX 3r1--Liquid depth 52» Capacity-8QQ__---A--- t ire Disposal Field: Distance from near��t well--��____-_.Distance from foundation,�25_.---------Distance to nearest lot line ------------ � { ] Number of,lines------�.__ Length of each line____7�--------------------Width of french---_---28 _--- � Type of filter material----1----- _-__Depth of filter material ----_U ---------Total length------ -_--___-------------------- Seepage Pit: Distance to nearest well__-------------------Distance from foundation---------.-........Distance to nearest lot line-__.--_.-____---_ ,! ❑ Number of pits----------------------Lining material---_------------------Size: Diameter------------------------Depth--------------------------------- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material--------------------------.__.-------. ❑ Size: Diameter------------=------------ -----------Depth----------------------------------------------------Liquid Capacity----------------------------gaIII s. Privy: Distance from nearest well--------------------------------------------------Distance from nearest building-------------------------.---_---_--_--_-. ❑ Distance to nearest lot line------------ ----------------------------------------------- Remodeling and/or repairing (describe):------------------------------------------------------------- -----------------------------------•----------------------------------------------- ---------------------------------------------- --------------------------•----------------------------------------------•-----•-------------------------------------------•----•--------------------------------------------------------------------------------..-..------ r --------------------- •--------.------------------------•--•-----•------------.----------------------------------------------------------------------•-------*------------------------...------•------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin;Local Health District. (Signed)---- D. _ A• PARR- _Fi--&- or Contractor} Estimator -------------------------- (Plot plan, shot ng size of lot, location of syste 'n relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-- --------------------------------------------------------------•-------------------------- DATE REVIEWEDBY ----------------V-------- -- ------------------------------------- --------------------- DATE----- BUILDING ATE----- BUILDING PERMIT ISSUED------------------------------------------------- ----------- --------------------------- ---------- DATE_-------- ` Alterations and/or recommendations----------- --------------------------------------------------------------------------------------------------------- r' -------------------------•-----------------------•-------------•------------------------------------------------------------------------------------------------------------------------------------- ----------------- ---------------•---------------------------------------•--------- -------- ------/------------------- ----------------------- FINAL INSPECTION BY:--------------- -- --------- -------- -------- Date---------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street �y�( Stockton, California Lodi, California Manteca, California Tracy, California 1 i ES-9-2M B-51 Revised W-2100