11472 - Laserfiche WebLink

Home Browse Search

r APPLICATION FOR SANITATION PERMIT Permit No. (Complete in Duplicate) � Dots Issued Application is hereby-made to the San Joaquin Local Health District for a permit to construct and install the work herein described. 3 This application is made in compliance with County Ordinance No. 549. 811 West Fifth Street ' JOB ADDRESS AND LOCATION------------------- --- - - --- --------------------------------------------------------------- Owner's Name---------- Domingo �_[rates ---= - - `-- ----.- Phone.----HO-- 5 -76LF2---- ----- Address------------------ Same as above --- - - - --------- Parrish & Sans 1 O 6-gb07 ContractorsName------------------------------------------ -- ---------------------------------- -----------------..---------- ------ Phone----------------------------------- Installation will serve: Residence (N Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel E] Other ❑ Number of living units: ---1-- Number of bedrooms __------ Number of baths ----'_ Lot size ---_SOxTOO Water Supply: Public system 0 Community system ❑ Private ❑ Depth to Water Table ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay_ Loam ❑ Clay ❑ Adobe 13 Hardpan ❑ Previous Application Made: Yes Ej No [ New Construction: Yes ❑ No P9 FHA/VA: Yes ❑ 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 we€1-----------------Distance from foundation-------------------- Material------------------------------------------------- ExisMtn No. of compartments-----------------_----_-Size-___--------_-_-------_.- � --------Liquid depth--------------------- Capacity----------------------- Disposal Field: Distance from nearest well------------- --Distance from foundation--------------------Distance to nearest lot line--_----------___. ExisEing Number of lines-----------------------------------Length of each line-------------_---------------.Width of french----------------------------------- Type ------------------------ --_Type of filter material-------------------------Depth of filter material--------__-_--._-------Total length--_.________----__-----------_-_'_--__-_ 5 t. - 5 t. Seepage Pit: Distance to nearest well____NOnC-'------Distance from foundation--- --------------D�3 c to nearest to I-qe--.----_--- ® Number of pits------- ------------Lining material11 ------I'OCk-----Size: Diameter------------______-----Depth------�------------------------- \ Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material--..----_------_---_-------_----__ ❑ Size: Diameter----------- --------------Depth--------------------- -----------------------------Liqui.d Capacity- - ------------------------gals. Privy: Distance from nearest well---------------------------------------_--------Distance from nearest building-----------_---__----__---------_- i ❑ Distance to nearest lot line-------------------------------------------------------------------- Remodelingand/or repairing (describe):------------------------------------------------------------------------------------------------ -------------------------------------------------------- ----------------------------------------------------------------------------------•--------------------------------------•------------------------•---------------------------------------•---------------------------------- - --------------------------------------------------------------------------------- -•--•---------------------------------------•----------- ----------------------------------------------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (SignedPARRTSH & SONS --_--_--------- - ----(Owner and/or Contractor) ByBILL---WRT GHT---------••----------------------------------------------------------------------------------(Title)--EST�_---------------------- ------------------------- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY------__9__x.9_Q---------------------------------------------------------------------- DATE----- —57 REVIEWEDBY------------------------------------------- ---------------•----------------------------------------------------------- DATE BUILDING PERMIT ISSUED--------------•-------------------------------------------------------------------------------------• DATE Alterations and/or recommendations-------- ---------------------- -----------------------------------=----------------------------•--------------------- ----------------------------------------- -------•------ --------------------------•---------•---------------------------------- ------------------------------------------------------------------------------------------------------------------•------------------- --------------------------------- !----- -------- '------------®' ----------------------------------------- ---------------------------------•------------------------•------ ---------------------------------- ---------------------------------------------------------------------------------------------------- -------------------------- R FINAL INSPECTION Date----- /- 7:/7----------------------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M , Revised 1.57 F.P.CO.