12018 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. ao _(Cornplefe in Duplicate) .-This- Permit Expires I Year From Date Issued Datb 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 co lia e'th o f. J;�Lvance No. 549. ND L T�N --- --- Owner's Name ------ @-�- JOB ADDRESS A OCAT ON - ------ - -------- - ------ - ------- ----------------- Phone----------------------....--------- Address----------------------- ------- Address----------------------- --------------------- - ........... --------------------- -- ------------------------------.....------•.... ................... .... ----------------- Phone.AD-,?-;?a -- -- ---- Contractor's Name --- ..... .. j— --------- -- ------------ Installation will serve: Residence V --Apartment House ❑ Commercial 0 Trailer Court [:] Motel [-] Other [I Number of living units: Number of bedrooms --- Number of baths./----- Lot -size - ---------------------------------------- Water Supply: Public system Community 'system El Private Depth to Wafer Table Z�ff Character of soil to a depth of 3 feet. Sand ❑ Gravel [] Sandy LoarrC'g',_Clay Loa 4* Clay [:] Adobe[:] Hardpan 0 Previous Application Made- Yes E] No $—New Construction: Yes Ej No Ej FHA/VA: Ye� No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) eptic. k Distance from nearest well --5V-1 ------ Distancefoundation--1Q 'from -- ----------- Mafer,idi ---------_ ________________________L- No. of compartments --- 1 - --- --------------- Size --- depth --- &-5 .............. <Osal Fief: Distance from nearest.well ... e -------- Distance to nearest lot line______. --Dist7ncofro-m fouinclation ... 16--' Number of lines -Length of each line ------ 4/,S'f ------------ Width of french.- c-2--!�/& ______Depth filter. rinaferial-Jf----- Total length --------- 4-ci - -------------- LXA, Type of filter material__ --- -------- --- -- ---- -Distance from foundation -440.---- Distance to nearest lot line--.57-- page F." Distance to nearest well-joe --- 11 Number of pits --- t -------- Lining material -;P—" - ---- Size: Diameter--.�3-9 --------- Depth --- ---------------- t� �. A!iW4 4 4 -------- F- --? Cesspool: Distance from nearest well ----------------- Distance from foundation -------------------- Lining material___.__-_--:.:-.____________- --_ 7r 0 Size: Diameter ------------------------------------- Depth ---------------------------------------------------- Liquid Capacity ----------------------------gals} Privy: Distance from nearest well -------------------------------------------------Distance from nearest building---,- ----------------------- ElDi5fan'ce;to nearest lot line ----------------------------------------------------------------------------------------------------------------------------------------------- Remodeli d ng nd r repair' i e ------ ----------- - - ------------- --- --- - - ----- -------------- e 3-1-4 ------- xa-,--r -------- -------- -- �JC4- -C-1 7 - ---------------------- . . ........ - -- ------ -- -------- - ---------- ---------- --- ------ ------------ ------------- --- -- -------- -- --------------- . .... .. ---- a ---------------------- -- ---------- --- ---- ------------------- ---- --------- ---- ------ - - ----- ---- f ------- , MnI r - ------------ ------ fx-� C - t, cafo I hereby certify that I have prepared this applicaflo and that the work will be "donei ac or ce wit an Joaquin Ccunfy ordinances, St�a laws, and rules and regulations 0 the S aquin 1,ocal He alt tsfrjo� 0�+ a quin I_ Di (Signed) -------- C - ------- ------------------------------- --- -- -- -- -------------- --- ------ --------- ---- ------- -------- -- (C5Wire;4PAWkrr Contractor) By: --------------------------------------- I ......... ------------------------------------------------ - -- --- -----(Title)------------------------------------- -------- ----------------- (Plot plan, showing size of lot, location of system in relation to w s. Lii1dings, etc. can be placed on reverse side). V, FOR DEPART NT USE ONLY APPLICATION ACCEPTED BY--,Zl-.A-------------------------------------------------------------- ---------..-----------------. REVIEWED ---------------------------- REVIEWEDBY --------------------------------------------- -------------------------------------------------------------------------------- DATE-------- --------------------------------------------------- BUILDING PERMIT ISSUED----------------------------- L ----------------------------------- .-,. DATE-------------------- Alterations ATE--------------------Alterations and/or recommendations: ----------------------- ---------------------- ----------------------------------------------------- ------ ------- -------------------------- ---------------- --------------------------------------------------------------------------------------------------------------------------------------------- - ---------------------------------- ---- -- -- --- FINAL INSPECTION ------------------ 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 Revised 8-'59 F'PLCC'