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APPLICATION FOR SANITATION PERMIT Permit (Complete in Duplicate) •y Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work heren �lescribad. This application is made in compliance with County Ordinance No. 549. Ifi Ar ��J JOB ADDRESS AND LOCATION..--___1102 University Avenue, Stockton Owner's Name------------- Robert E. Wilkinson b-+-5220 -----------•---•---------------------•- Phone Address________________ Same Contractor's Name-----___-.• �• A. PARRISH & SON,Ss INC• ---------- Phone-----9"'_96.07------------ i •----------------- -------•-------------------------------------------------------- ; Installation will serve: Residence Apartment House ❑ I �] p ❑, Commercial ❑ Trailer Court ❑ Motel ❑ Other Number of livingunits: ,Z_ -__ Number of bedrooms 2 75"x75 Number of baths Lot size ------ Water Supply: Public system ] Community system ❑ Private ❑ Depth to Water Table 4P_ ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑• Clay ❑ Adobe A Hardpan ❑ Previous Application Made: Yes ❑ No [ New Construction: Yes 4] No ❑ Replacing cesspool 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__NPne___Dista rom foundation__10 ________.Marial-- CC Brack 99 No. of compartments-_-.__�2__________________Si # 2 Z�� 3>MLiquid depth--- - Capacity----------a--� - Disposal Field: Distance from nearest well__N0ne---Distance from foundatio ...........Distance to nearest t�line_B_____--------- q. Number of lines___1------------ Length of each line------- Width of trench `t _._,__ Type of filter material-___l �__Rk Depth of filter material___.__1 --__^- Total length------ ! t Seepage Pit: Distance to nearest wel!----N©nC------Distance from foundation___..______________Distance to nearest lot line_._ _____f. __Linin material� C slSize: Diameter----3- --------Depth. 'r ( _ • Number of pits__-____�________ g Cesspool: Distance from nearest well-----------------Distance from foundation------------------..Lining material___________._________________________ ❑ Size: Diameter----•---------------------------------Depth--- ------------------------------------------------Liquid Capacity----------------------------gals. Privy: Distance from nearest well---------------_---------------------------------Distance from nearest building-----------------------------------------. ❑ Distance to nearest lot line------------------------- ------------------ --------------------------- • Remodeling and/or re airingg ((cc��escri ;-*This system will replace existing cesspool and is 9 / p a b ---- ------•-- - what can be co ruc ed on. tha space ova�Iab1e*___��' ie '�j x�S srs� f s--------------- ------------------------- ---------------- mostly taken up With__1 i'Iairigs�-----Thi'---sys ct----iso---t�--'ties---aeeeptab-le...fur--w----•------ ---------------------- F.H.A. loan deo.----on eritir-e...premf s e s ---- ordinances, State laws, and rules and regulations of the San Joaquin Local Health ------------------.....................-- --- -- ---- ------------------- ----- 1 hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County District. a Si hed D• PARRISH & SONS, INC. . • -- ------------- - --- ------------ ---- ------------------------------------------ 9 )------------------- ------- -- - - - -------- - - - { Contractor) t� Estimator � BY. R --------------------------------------------------(Title)------------------------------------•- ------ [Plot plan, showE sire of lot, location of s+ern in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY---- - ------------------------------------------------- DATE-------- REVIEWED BY--------------------------------- --- ------------.------------------------------------------------------- DATE-----e - BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE-------- --�.f` - Alterationsand/or recommendations----------------------------....--------------------------------------------------------------------------------e--------------------------- a ----------------------I----------------------------------------------,-----------------------•---...--•.._.......... ----------------------------------- --------------------------------------------------------------- --- --- -------------------------- ♦ b FINAL INSPECTION BY:' --_-- 's -Y Date----- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oafs Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California E5--9---2M 8-5) Revised W-2100