20587 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: _ Q 5__s, Permit No. -�-•-- ---- --------- "---------- --- APPLICATION FOR-ANITATION PERMIT ------ --------- ------------------------ ----- (Complete in Duplicate) Date issued --�-- ------------------------------------ ---- --" ---- --"- -------- This Permit Ex fires 1 Year From Date Issued ------------ --- ---- is hereby made to the San Joaquin Local HealthDiNoc 549 a permit to construct and install the work herein described. Application Y , This application is made in compliance with Countt=Ordinance `[ -------------------- JOB ADDRESS AND LOCATION-------------- ------------------ Phone__"1-------- ------------- Owner's '-------- -- ------------ Owner's Name. -------------------- ----------- -•_ 3 ..�-�-------- Address--------------•----- ---------- - ----- ------------ Phone 1` f ---- ------------- -- - - ------ --- ------ ----- - Motel ❑ Other ❑ Contractor's Name--------- "--- Trailer Court Apartment House ❑ Commercial ❑ Installation will serve: Residence AP ------- ---~-----•- / _._ Number of baths _ .___-- Lot size ------ - Number of living units: _/ -- Number of bedrooms Depth to Water Table 7-�ff. Community system ❑ Private ❑ P Water Supply: Pubiic system [� Cla Loam ❑ Clay ❑ Adobe Hardpan ❑ Character of soil to a depth of 3 feet: Sand E] Gravel ❑ Sandy Loam ❑ Y FHA/VA: Yes F] No ❑ �ew Construction: Yes ❑ Previous Application Made: (If yes,date_..---- ..--- l NO 1� �V i TYPE OF INSTALLATION AND SPECIFICATIONS: s available within 200 feet.) No septic tank or cesspool Permitted if public sewer t -_J r � Distan�e from foundation----IQ- --- Material_- P 5 � ---_Ca acct Septic T Distance from nearest welIAYI-�J- }h_-" _---------____ P Y , No. of compartments----r�--------- -- ----Size - � Liquid dep, t. , Distance from foundafio n.-,�Q-� ;Distance to nearest lot line_-5------- �/ [s Width of trench------�� --�';'----- Disposal eld: Distance from nearest well. Length of each line/ZR---S` ;�- Number of lines------- ---- ----- -- ---Total length------ ----------=-��--�T-� I_ " _jEG De th'of filter matenal_��----- Type of filter material-_ _ ! p Q` _ Distance to nearest lot line--�-S -- i Distanc�)p,.n foundation-3SeepageSize: Diameter-- 3 ]`� Depth a �sDistance to nearest weiL- """ Linin material_ -G 1 Number of pits. g gals. Cesspool: Distance from nearest well--'---------- ---Distance et+h Ce-from foundation_-----___-- --__-Liquid Capacity_._ ------,---- ---------.--- Lining material------------------------------------- Cesspool: -- -- r ❑ Size; Diameter--------------------- -- p ----. Distance from nearest building------------------------------------------ Distance --------------------- ---------- 1 Distance from nearest cast--------------------------------------- ----- -- -- ----- ----- ----- ----- ------ - ----------- Privy: Distance to nearest lot line----------------------------------------------------------------------' "v`�`� ! ; Remodeling and/or repairing [describe}:_ _ ----------- -- ----""--------- ----------------------------------• - -- - ---------- ---------------------- ----- --------- --------•----------- --- -------------- - ---------- ------------ I hereby certify that l have prepared this application�joqu-.andhLcalkHeal�heDistric}n accordance with San Joaquin County Y ordinances&Sfate laws, and rule and r ulations ocaner and/or Contractor) 5i ned ------ - it eeon ---rse rse side). [Pio+ plan, showing sixe of lot, location of s stem in rela ion +o wells, bui rags, etc., can 6e p revs FOR DEPARTMENT USE ONLY >> DATE------ ------- ----o-/-- -------------------------- i APPLICATION ACCEPTED $Y_____--- ---- ' �' ``e ----------------- --- APPLICATION - = __._ DATE -------------- REVIEWED By--------------------------- --------------------------------------------------------------------------------------------- -- - •--- rJ�r, C�� - -- ��`' ------ BUILDING PERMIT ISSUED c /f ----- c _- DATE- - Alterations and/or recommendations:_.--"--' - - -- --- Lj -�---- ------ - -- -------- ------ ----- --- - ---rl- z --- -- Olk ---- -"--- 7 ------------- --�'----- C7 - _.-. _ - _ ________________________________________________ �pp�� __ - - - ` �� yea �� ------------------ -- - z f�rd, f r'� d ------- r / - - FINAL INSPECTION BY:------------ --------------- -- :� � ��• Date--- -- ---- --- ---- - SAN JOAQUIN LOCAL HEALTH DISTRICT 124 Sycamore Street Manteca,California 205 West 9th Street 300 west Oak Street Tracyr California 401 E.Haxetton Ave. } Lodi,California Stockton,California F.P.Gd.