10256 - Laserfiche WebLink

Home Browse Search

1 PERMIT Permit No, ..��...•.. ...L? �Yl APPLICATION FOR SANITATION R 'Z '�' 22 Y (Complete in Duplicate) v � .� Date Issued ._._...._.��_. rApplication is hereby made to the San Joaquin Local Health District fora permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION ,...__.......00„S- - _.. �J. �- ".......................................................... --....... Owner's Name--- ---------- �'-r,�l. 1- �/�-.t— �r Phone. ` r Address.. �` ,7� ' -- -0 E - JJ�� Contractor's Name ... .....-•... . ............ Phane.�0lP. " .�. Installation will serve: Residence &;Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ n ,,,.-- Number of living units: _�Zmunity ber of bedrooms _ Number of baths/--_____'Lot size ...... Water Su ply: Publics stem s stem Private De th to Water Table ....._.. ft.PP Y' Y Y ❑ ❑ p t Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ardpan ❑ Previous Application Made: Yes E] No New Construction: Yes E] No FHA/VA:Yes F-1No 1 TYPE OF INSTALLATION AND SPECIFICATIONS: x (No septic tank or'cesspool permitted if public sewer is available within 240 feet.( U Septic Tank: Distance from nearest well.................Distance from foundation..................,.Material No. of compartments___>. --- _ --.-Size _.•.......... ............Liquid depth --------------- Capacity............... Disposal R Distance from nearest'well---l►nw*d, Distance from foundation Distance to nearest lot line/ ,. Number of lines---------1 _.. _-.-_-Length of each line., Width of trench Type of filter material---ro G)rDepth of filter material_----- t�.�� Total length.........3.4-J ................ Seepage Distance to nearest well- fir-Distance from fnundetion.-JA-_r Distancetonearest lot line;Q [] Number of pits......1.-*:----------Lining material.... jGt-C_-K"---Size: Diameter----- ----.Depth---.. "-•.......... Cesspool: Distance from nearest well.._.....____.....Distance from foundation Lining material, ---- ---- -❑ Size: Diameter---- Depth_-,- .......... s Privy: Distance from nearest well -- - --.'„-------I....... . ._...:Distance frgm3nearest building.-_.-._ _....... ......:..........a ❑ Distance to nearest lof liaae -- --- -------- ,. .-- /!' e . Remodeling and/or repairing (describe):---; ---- {/- o ---- �nl:! ............. -------------------------....................... ................. - --=------ --------------------- -----------.............................-----• --... ------------4 .......,.................. I hereby certify that I haveprepared.#his application and that the work will be done in accordance nth San Joequin bounty ordinances, State laws, and rules and regulations of the San Joaquin Looel Health District. t (Signed) •. ••-- -----••• - - -- ..(Oww..and/or Gon#ralc* }' -- ......................................--- ---••- ------- ---- --- .... • ---• ( BY•----•- .. Plot Ian, showing size of lot, location of s stem in relation to wells, buildm s, 8#0., can t e; a on re st side ( P 9 Y 9 FORP fPARTMENT USE ONLY APPLICATION ACCEPTED BY---------- - -•----- ------------ ---•- RATE--- -Q ..Zt-- .. ----••... " REVIEWED BY------- --- -•--•--- ----------- ---•--- ---------------------------------------------- . ----- --- ---- •-------- ------= `DATE ....:.,,. .. ` ........ ',, BUILDING PERMIT ISSUED------------- - ----- DATE ---..................................... r Alterations and/or reendations -...................' '. ._..................................................... -- -•-•--..... ..... .... ... ... U-c . ' a3 -... - 1 , 'FINAL INSPECTION BY:----------- -----� Date.... SAN JOAQUIN LOCAL HEALTH DISTRICT 14 ' 130 South American Street 300 WesF" I[k`Str,C '132"S" more Street 814 North "C" StrMt Stockton, California Lodi, Califorala Manteca, California- Traoy, California ES-9-2M Revised 1.57 F.P.CO.