13917 - Laserfiche WebLink

Home Browse Search

- ` OR OFFIJZE USE: =� APPLICATUON'FORISANITATION PERMIT Permit No. ="` - (Complete in Duplicate) ' Crate Issued ��plication is hereby made to the Sun Joaquin Local -eo|fh District for a permit constructhoand |ndmU the work han^Yn described. Is is made /n compliance with County Ordinance No. 549. ' ` JOB ADDRESS AND, .. -----" ---------------'----''--'''—'---'----'' Owner's Name .' .. Phone ...... .............................. Address ..................... ' ' _--- ......................... Contractor's Noma-'_ ' ——`----''_--_.-__.-'--_'------. ..~..~^'-- ------------------------- Installation ----_—_- InstaUmtionwU 'smrve: Residence [] Commercial ] �� [��[��0 / ��e [] Number ofliving units: Number ofbedrooms Number of 6uH,m Lot size Water Supply: Public system E] Community system C1 Private [-] Depth to Water Ta6|m�� ft. Character of soil to m depth of. 3 feet: Sand [] Gravel [] Sandy Lnu [] Clay Loam [] Clay [] Ado6w�ardpwn [] Previous Application Made: (If voa.6oto-------------------- No wCuno+mcf|on, Yes [] No &3---PRW/VA.Yes [3 No ~ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well ---------- ...... Distance from foundation -------------------- Material --------...-----.__ ' -AcK/_�,/No. ofcompartments --_--_—. Size '-_—_---_—_Liquid 6op�h---------- -------------- Capacity ....... ---_-'' � Disposal riDistance from nearest well ----------------- from foundation ___--.-Distance tonearest lot |inm---_—_' ~l� Number of lines ----------------------------------- of each line '--'—_—'---'YY�H, of fw�c6__—'---............ ' *' Typo of filter material ------------------------- Depth of fi|har mu+e6mL--_.--'-7o+u| length .................. --.—__--. L� Soeou : Distance to nearest well ----- -- D -- nearest loVIine � E�~~ Number of p�o--.I_--.-Uning mu+m6m| --3�e: Diameter-_;? ^---Ooof�—.=��^~ __- L000poo|: Distance from nearest well_ -------------- Distance from foundation ------- Lining material --__.---_......... Dr � [] Size: Diameter .--''_.—_—_'—Dep| .—_---_—.__---------------- ... Liquid . Capacity ------------- -------------- gals, � Privy- Distance from nem,00 well ------------------------------------------------- Distance from noorw" bdIding------ ------------- --------------------- Of 11 Distance to nearest lot line Remodeling and/or repairing (describe): --'''—' ______.______ __ -___—................... . ---- ------------------------------------------------------------------------------------------------------------------------- --------------------- ------------------------------------------------------------------------- , --------------------------------------------------------- ----------------------- ------- --------------------------------------------------- ---------------------- ----- ------------------------------------- ------ ...... | hereby certify that I havethat �e work will be done� m��6�c �� San J�u�� wu�v�~� ordinances, State |ewn. and rules and mmguLm�mms'*fthe San Joaquin Local Health District. - '`' ' / (Plot plan, showin of �of, liocaf:�:ion of system in relation to wells, buildings, etc., can be placed on reverse side). V. Alterations and/or =�a" --' ^ ---'---'—'--''--_'—'—_''—'—''--'—'''—'—'---''—_''—_'—_.'--_'—'''---_-'---_—.'—''—'_—.'_—'--'. --''--------------------'----------'----'---------'------------'---- '—'—'— '''—''--''—'----''—'''.—''—'''---'_---''--_-_' FINAL INSPECTION D�t�---.��-'z=o��1 --------. ~ SAN JOAQu|NLOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore street u*wWest 9th Street mwxw^".California Lodi, California Manteca, California Tracy, California ,*-9 REVISED *'""nM°'°/ATLAS -