3775 - Laserfiche WebLink

Home Browse Search

- �' APPLICATION FOR SANITATION PERMIT Permit No. X77__ (Complete in Duplicate) _ 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...____...2309__.ry_+-Asacla Street, Stockton,. - ----------------------- ---- Owners Name.........................................Rex Stewart --------------- Phone-------37591a__.____ Address....................... Same ------------••-------------- Contractor's Name.................................PARRISHINC•..---------------...---------------------------------------------------. Phone........... "4607 Installation will serve: Residence:n Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ---;L Number of bedrooms ._3_. Number of baths ....Z. Lot size ____-___60 '- X _110 f--------------------- Water .--_--- -Water Supply: Public system [& Community system ❑ Private ❑ Depth to Water Table AA ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam❑ Clay ❑ Adobe X Hardpan ❑ Previous Application Made: Yes ❑ No [?q New Construction: Yes ❑ No ❑ Supplementary Drainage W TYPE OF INSTALLATION AND SPECIFICATIONS: Q (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well_________________Distance from foundation_______...•--______.Material------------------------------------------------- P q p E�Sti No. of compartments Liquid de th______--_-----__--- -------Capacity----------------------- Disposal Field: Distance from nearest well_________________Distance from foundation--__-__-______--___.Distance to nearest lot line--_--___---_--___ Existing Number of lines-----------------------------------Length of each line----------------------.._-----Width of trench----------------------------------- Type of filter material_________________________Depth of filter material-----------------------Total length.......................................... Seepage Pit: Distance to nearest well...NOIIe_._-.__Distance from foundation_15_t___-------Distance to nearest lot line-------1-------- N Number of pits--------1----------Lining material..._.CC_ BrAAjX: Diameter----33__-----------Depth Z .----------------- -- 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 repairing (describe):-----•--- ----------- ------------------------------------------------................................................................................. --------------•----•---•-•----••---•-----•----------------••--••--••--•--•----•-------•----•--•----•••••--------------•-•------------•---------------------------•--------------------------•-•-----------------••----------- ---------------•------------------•--------------------------•..--------------•---------------------------•------------•------------•------•--------•-------...-•------• .......----••-- ------------------------------ I hereby certify that I have prepared this application and th the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Jo uin Local Health District. PARRISH INC (Signed)......... --•---••-•--•-•-•-----•-------------•-- ------------ -----------------------------------------•------------------------- -----------( Contractor) By:--•••------•---•--. -- -----(Title) Estimator --- - ---- ---------- ------- (Plot plan, showing six of lot, locati s e ation t# ells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ----------------------------------------- DATE .- ---------------- --- REVIEWED BY- • DATE---- . BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------.. DATE------_---------•- - ------------------------------- Alterationsand/or recommendations:............................................................................................................................................................... --.-_.................................................................----- ----------------------•-......----------------------------------•------------------...------.--------•----------------------•------------------- -------------------------_ -------------------------------------------- ---------------------------------------------------.................................................----------------.......................... -----•-••--•-••---------------------------------------•-------------------------------•-------------- ----------------------------- ------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------ _-4, FINAL INSPECTION BY:.: ----------- ---------- Date.. 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 10-52 Revised W-2100