78-105 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: --------;el-- ------------?*--------------- ---- `t _ p � _ _ ----- - --------- -- APPLICATION FOR SANITATION ----- - - . PERMIT �Or�r Permit No. 1 � -7 -. ---•-___ (Complete-in Duplicate) ----,� ------------ ----------- --------- ---- - pate issued ------------------••-�- ------------------------------- This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION----------/S------ ---------- SZ,4AOAr ----- /�B-_r��$i_..___t �---- ��5' A•�` Owner's Name------------ •o-'rr---------- ------ ---•---- ----- - ------- Phone----------=-- ---------------•----- -- -/ ------- � �� -------mss 1�. / - ------------------- Address__.._. _ __ Contractor's Name--------- _!_�- 19_ _ ------ a ' =- --I . - --- Phone_:_ _7_.!-_ _ _-- - ' ICS' Installation will serve: Residence JZ Apartent House Cona�nercia rai er Court E] Motel E] Other ❑ Number of livingunits: __ -.. Number of bedrooms -�__ Number of baths__-.._ Lot size __.-- [T__ / 7 ------------- Water Supply: Public system ❑ Community system ❑ Private X Depth to Water Table ------ _ ft " Character of soil to a depth of 3 feet- Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam 0 Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: (If yes,date__-_-------------- ) Nog New Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS- (Nop P n p7 -,.X- .nd • . .`Q---------Material��. �'CfAlalzr�- _---------- No se tic tank or cesspool permitted if public sewer is available within 200 feet.) ( Septic Tank: Distance from nearest well-_ :____I]is{ante from fours anon____ No. of compartments------------- Size__ Li uid de th_-- _ . -- _-_-_Capacity �.]C � Disposal Field: Distance from nearest welll;,�,_.'`Distance from foundation,3�___-____---.Distance to nearest lot line-la_.-._____ a Number of lines ---------- N__ ____Length of each line__ ------Width of trench_____ ________!.________.____ Type of filter material-� j4.c_4 Depth of filter material_-_� --___--___Total length-.----- _/' Q_______________�_- -� ,�! i Sea Pit: Distance to nearest well_. Distance frogs fou dation---j?------_ D�fance fo nearest lot iine-la-.-_--_ i Number of its___ -_ 409. Diameter__y��>2..__-Depth-._ Z7 �h F I� P --------Lining mater f Cesspool: Distance from nearest well ------ --------Distance from foundation----------------- ..Lining material__-___-___------------------------ ❑ Size: Diameter- -- ------------- -------- -------Depth------------------------- - - ------------------- -Liquid Capacity- - ------------------------gals. IPrivy: Distance from nearest well..--------- ----------------------------------- Distance from nearest building-.--------------------------------- ------------------- ❑ Distance to nearest lot line ---------------- 4 Remodeling and/or repairing (describe):--------' 3�.�I{/�/ --- ------�.,9,elA------ ------------------ / ` --------.5,� . "R'r -- -----------------------'-----------------------------•------------- --------------- -•-------------------------------------------------------------------------------------------------------------------------------- . I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin Counfyf ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. � -- ---- P_�_______________{Owner and/or Cont actor) (Signed)•- ------------ � --------- BY: / r -: — /lam - ---- --{Title)----- � {Plot plan, showing size of lot, Iota on of system In relation to wells, buildings, etc., can be placed o reverse side). ' �Olk DEPARTMENT USE ONLY 70 APPLICATION ACCEPTED BY G.,t/-- _ DATE ,� J�- ------------------------- --- REVIEWED BY--------------------------- ---- --- ------------------ ---------------------•-----------•-- - DATE------..... ----•---------------------------------------- - ----------------- -- -- lBUILDING PERMIT ISSUED---------- ------- •--------------------------------------------------•-----I------ DATE-------------------------- ---------------------------------- Alterations ------- -------------------------Alterations and/or recommendations:---------------- -------_----- ---------------------------------------------------------------------------------------------------------------.. •---- ---------------------- --- ------ ------------------------------------------------- -- ----------------- ------------------------------------------------- ---------- f ---------------------- -- ------------------ -------- -- ----------- ----- ---- ' ----------- --------- --•-------- ------- ------------ - ------•--------------------- ---------------- FINAL INSPECTION BY:-..---�N ._. - Date r---'----- - SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Slacklon,California Lodi. California Manteca,California Tracy,California 1 E.H.9 2M 1.67 Vanguard Press t i