2451 - Laserfiche WebLink

Home Browse Search

>. .. Ad APPLICATION FOR SANITATON PERMIT Permit No. 310--(_.. (Complete in Duplicate) DateIssued ?yam'✓ Application is hereby made to the San Joaquin'Local'Health District for permit to construct:and install the.work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION.- . �', � -- - +c4-"'L------- -- -------------- ------------------------ Owner's 'Name......... Phone - --- - Address Contractor's Name.- ,= C-- Phone: I-.CO Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ M9W 0 Other Number of living units: /.. Num r of bedrooms /__-_ Number of baths _ ____ Lot size-._-- -_. _- ,+� y Water Supply: .Public system ommunity system fl Private ❑ Depth,to Water Table .-.._.. ft. - [w Character of soil to a depth of 3 feet: Sand Gravel ❑ Sandy Loam ❑ Clay Loam [], Clay ❑ Adobe ardpan ❑`i _ Previous Application Made: 'Yes ❑ No New Construction: Yesto ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if pu sew i within 200 feet.) Septic TARK Distance from nearest wel an om�fo~undafio .....Mate, 1 - ..... No. of compartments A ize. -�__•-Li Liquid de th--- ---------------Capacity � a p ---- ---•---�f----- Dispo al d: Distance from nearest well_ Distance from foundatio Distance`to nearest lot hag 'Number of lines Length of each line �� Width of-trench-- ,�� Type of filler material _-__.:--Depth of filter`material__ ---------Total length.__--., Seepage Pit: Distance to nearest well--------------------Distance from foundation_.---_--_-•-......Distance to nearest lot line.......----_-_-. ❑ Number of pits----------------------Lining material-.-.. -----------------Size: Diameter•__---------------------Depth .__•_-__ ,-_..a............ Cesspool: Distance from nearest well------...........Distance from foundation--------------------Lining material._ ._------ .------------------ Size: _-....__-----•---.Size: Diameter----- -------------- -------Depth....... -------- --- - ----- -- ------Liquid Capacity ------- -------...gals. Privy: Distance from nearest well.... ......... -----------------------Distance from nearest building...---_ __--'-.__ ..-_---------------- ❑ Distance to nearest lot"line_._ --------- -- -- -• - Remodeling and/or repairing (describ -•- ,/ --------------------------------- ------ ------ ---- ---------------- ------- -------- -------- ---------•--•--- ------•-------------------- ------- ------------ -- ---------- --------------------- --------------------- ----- ----------• - - ------- ----- ------ ------ - ------ -------- -- hereby certify that I have prepared this application and that the work wilt be.done in accordance with San Joaquin iCounty ordinances, State laws, nd rul alld regulon ns the San Joaquin ocal"He District. <> Signed) - ,-- -- - .(Owner and/or Contract) By ............... : -- -----------------------------------------------------------------.....(Title)--------------------------------------- ------ Plot Ian, showing site of lot, location of ( p g system in relation to wells, buildings, etc., can be placed on reverse side). ' FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY - ------------------------ - ------------- DATE .•---•-•- REVIEWEDBY- ---- ----- ---- -------------------------------------------------------- ----- --- - DATE-----------7--------------------- BUILDING :.. ....... PERMIT ISSUED---------------------------------------------------------------- ---------------- --------- --------- DATE..._•---------- --------- -----------------•------------- Alterations and/or recommendations:- ------ - ------ - - .-...., •---- ---- ------•----------- --- --------------------------------------------- -----u.._ ...-------------- 9 r- FINAL INSPECTION BY:_-- -- ` Date. -•. . SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street `A814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy. California- ES 9'-2M 8-51 Revised W-2100