77-589 - Laserfiche WebLink

Home Browse Search

,�,. FOR OFFICE USE: FOR OFFICE USE: APPLICATION FOR NITATION PERMIT -- ------- -"+ (Complete., i Triplicate) ---------------- '� ._��- . Permit No.------------------ - - `' � Date kssued�_- �7 -- ------------------- This Permit Expires I Ye This Date Issued Application is herebymade to the San Joaquin ocalOrdantancpelsNo. 549 and exist ng Rultrict for a permit to tes and Regulations:.ruct and install the work herein described. 1 1. This application is made in compliance with County _ _ .s and � t //� l� - GENS Ph TRACT -_------ -- - - ------------------ -- ------ -- -- c JOB ADDRESS/LOCATION_.__.C.7=---_ -- - - - _ r► ` - - F Owners Name.-- 1 tI., / ` ? o ------zip --------- ------------- .. City_ - Address--- �-' _ t r...�- o ,.,.. l License # AO-- l�� Ph ne ---------- 1 Contractor's Name_ - ,,� }. , a `' ment House.❑ Commercial ❑ Trailer Court, ❑ �.� Installation will serve: i Residence El +Ap �. art JAotel ❑ Other - ,': t Si - ---------------------- ----- - -- .. _. ... - ---_Number of:bedrooms ___ Garbage-Grinder=---- _Lo 'z4._ ' -_ .Dt3 Number of.living—units:- --------------------:-- ,- - ,T " t -- -- - t C1a ❑ Peat ❑ Sandy Lo Priya e ❑ Water Supply: Public System an name__-- .Silt yLoam ❑ Clay Loam Character of soil to a depth of 3 feet: Sand ❑ . ' ,�-ti F ' kv type i Fill•Material. '-----If` es, a-----------= - I i :Hardpan ❑ Adobe,D, �� : , e j,size of lot, location of.system elatifony'to- ells; buildings, etc. must be',placed on reverse side.' \\ (Plot plan showing, NEW INSTALLATION: (No-septic.tankJor Iseepdg p p permitted if public sewer is available withiL 200 feet) h _ i i ....:.-..." .. ,..+Size-- --- iqu"d Dept - PACKAGE TREATMENT [ ] SEPTIC TANK"(.] `4•___Capacity_." - TYPe= =': Material- .-, -- - .- _No. Compartments "C �. �. Foundation Pop. Line. Distance,to nearest: Well -_ E..t w� �r i Total Len igth _. '-- Len th.of each line / G- LEACHING LINE ]. No, of Lines. g ------------- De th Filter Material-- _-_-.-_-- ------ 'D' Box.---------- Type Filter Matecral___ P .. -- i .. Line-; - - ------ -------------- Foundation I Foun ation__ Property L' ' x ;.:t r d Y s�,� N t- D ptli.::04--`Diameter-: Number o❑ Rock Filled e- � SEEPAGE PITL`s]'a" - - Size--------------- -- ----- ---- t :f " } '- -- � .�.. . . Rock Water Tablet Depth- '------=-1-------- . "._ -, -----'Foundation--------------- -- Prop. Line Distance to nearest: Well__.= -Date------------ ------------- ------ -----------) ,� . REPAIR/ADDITION (Prev. Sanitation Permit#i , "-°=- - --- Septic Tank (Specify Requirements).__, p.= — - _ ---- --- Dis'posal Fie y cify Requirements). _ ------------- ------- -----------;- --- _7 ----- -- --------- r ------. - ---------------------------- ^ 7 -- - 1 - -- - -- - -- -- v.. _ � _ '�{Draw existing and required addition on reverse side}`r'"'T' I I hereby-certify that'l have prepared this application and that the work will be done in accordance with San Joaquin County •San Joaquin Local Health District. Home owner or licensed agents Ordinances, State Laws, and Rules and Regulations of the signature certifies the following: � y person in such manner as A "1 certify that in the performance of'the :work far which this permit is issued, I shall not employ any sation law to 'become subject to Workman's ComPens .of California." f - - ---Owner Signed ------------ ------ I Tit e ----------------- - --------- ------ f o her than owner) ,. FOR DEPARTMENT*E ONLY { ' - -DATE.--- ------ ------ APPLICATION'ACCEPTED BY-. - ---------- -- --- DATE - ----------------------------------------------- ----------------- OF LAND NUMBER.. : . ------------ ADDITIONAL COMMENTS--------------------- ------------ - AT _ --------- ---=--------- ---- = - - - .----- ------ ------ -- --------------------------- ------------------- ------------ -- -------- 6�---- ---- --- ---------- ------ --- ----- ------- ----------------- -------------- --------------------- p ---------------- ------------ - -------=-Date.'- -- - --- ---- Final Inspection b "" - �----- - - p y;-"_�_. __ -_. - V F85 21677 RfV7� SAN JOA UIN LOCAL HEALTH DISTRICT EH 13 24