77-846 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE 'L FOR OFFICE USE:" p,PpLICTION FOR SANITATION PERMIT .ey % Permit Nd,./.- ---- - ------------------------------------------- (Complete in Triplicate) ---------------------------------------------- �� Date Issued�°-�,, - �7 -----------------'------- ---------------- -------'------ This Peirr it Expires 1 Year From Date Issued r Application is hereby made to the San joaquin Local ucountt Ordintanccestrict for a No. 549 and existing Rulrmit to truct and install the es and�egu,latiQns: work herein described• This application is made in compliance f r ti - -- ...- + . ".CEN -- —r— �SU �i�2A -: � JO.B.ADDRESS/LO TION—_ - t ' Ow ter's Name - ------ _ one . Q� '} - ------Cite ,{ Address--- t l . - �+ eey�ff r�► s s Y r__,4 ,�'�-_� -,License #_0, F-6[ [ Phones s - Contactd's-Name ^ ." ,�. 1 ' Residence ❑ Apartment Howe❑ Commercial Trailer Court ❑ . InstaIIatio will serve: {{ Lj L} = M tel ❑ he -------- -- --- d _-- Garbage Grinder-_'i!" -Lot Size-__-- -- Number o living nits:_-:- '-.-,Number of edrooms"." "- rivat r: s P e� Ii : --_- ----- Public S stem, na Wate'w• Supply: Y 1[�.,.._.�!�._ . ,. (y - Cla{{ Loam ❑ ' Silt Cla Peat San Loam❑ Y Character of soil tfi a depth of 3 feet: ! Sand ❑ ❑ t . Y ❑ # Hardpan ❑ ;�Mob� }_Fill MaleriaL..--'..----If Yes,type---J-------------------------- > - r buildings, etc.�rrlust be placed, on reverse side.) (Plot plan, showin6 size of lot, location of system in relation to wells, 441 p it �'ermitted if public sewer is available within 200 feet,} i NEW'IINSTALLAT14N: {Nofseptic tahk or see age p p f, Size Li vid Depth---S SEPTIC TANK � /�-� �-�.�- -----'- --- --- -- q REATI)11ENT [ 1' , ---------No. Com a('rtments----- ---- PACKAGE T ` F ate•rial_ P [ l Capacityll ([+r _ Ype ` l r p P1 Po . Line _ Foundat on_.- 6 �,.— r i } 4 Distance #o nearest: Well._" .- P ; 4 Total Length._:-- - -- - each line_.-_._ - _ r , LEACHING LINES , l Depth Filter Material "-=_f ---- -------------------- Na. f Lines = ._ _ e .g. ► # 4 ;D' Box-L'f-` Type Filter Material_% P .• r Pro a Line_.-__'A ri --- -- .Foundation - = p tY Distance to ne rest: Well SV ; i - - + ( ; 4- - � .. .: . -� �� .�' � Rock Filled Yes�' N°�❑ E 4- r. Number , SEEPAGE P.iT P {►- - , '- 1Naterb '.Depthmete .9 -- A�A ' � � � � ---- - -----.Rock Size-- -- .7__!7_ ----- ------- '--- ------------------ '" # 'D ! Fo dat n. ie ----- Prop. Lim`' --------- r Dt§fcrrice:ta'rleares -- REPAIR/ADDITION (Prev.•lSanitation Permit#.- -----`------ ----- r -------- Date------ -------- ------- -- y -y. l ----- --------- --------- t 3 Septi Tank (Specify Requrements)- ------- ------- - ----------------- ---- -- ( Disposal Field (Specify Requirements)- ? "= ---------------- - - -- _ � } F , � - : _ ti ' --- -- _ _______________ ------[ 4 4� 3 - p (Draw existin and required ad"ditian on reverl;e side} ' [ 9 4 application and i#hat the work will .be done in accordant with San Joaquin County I hereby certify that I have prepared this app i ` eats k, J4 Ordiri'ances, State laws,t and Rules and �RRegulati�ons of the San Joaquin Local F�ealth District. Home owner or license sag signature certifies the following: person in suchnranner'_ps I " "I cerfify that in the performarice of the work for which this permit'is issued, 1 shall net eMploy any p to become subject to. .Workman's. Compensation laws of California.'_' . lARfNCE'$ SEPTIC & $E 1EFt SERi/Ica f, } n . ----------- - ------- : Owner 3 So. Oro Stc•cktai%, Calif. 95205' Signed---- --- --- L �Gfl f�C� L �1 ' 2Fi717 B -- i (If other than owner F EP. TMENT USE ONLY' APPLICATION ACCEPTED BY --_-- - --- --------DATE-$ `r DIVISION OF LAND NUMBER----------- ---------------------------- ---- --- -------------.=------------- "- ----- ADDI IONAL COMMENTS----------'------- , -------------------------------t f F 4hA`�- ----------�,n - - = _ , - .-------_--_-- - ----------------------------------------- ---- - -------------------------" ----- ------------ ------ ---------- ----------------------------- f -------------- ----_---- t----------- Date.. spection by: F&5 21677 REV 7/76;� 3_M _- Final - {'', EH 13 24 SA�dAQUIN LOCAL HEALTH DISTRICT -.