11379 - Laserfiche WebLink

Home Browse Search

FG.., SANITATION PERMIT Permit Na. I- -- --�•- r' (Co p1e#e -in-Duplicate) Date ls`sued-_____. the`San oaquin Local Health District for a permit to construct and installthe_ "work herein described. Application is hereby made to This application is made in bm,pliance ith County Ordinance.No. 549, ,fir _ JOB ADDRESS AND LOCATION-__ - K - a �� ------------- -- � - -- Phone_--------------------- Owner's Name-------_=- -------------- - - - - ----"` �. rAddress---------------- ��'--• --- -----�----------'�-- ----�r�----- t----�-----;,;,---------=-----« -- ----�------- ------------------......_ --------------- ---------Contractor s Name y .,�Cr ------;- �1--- --'�-'� �-- a{ - Phone-------- ---=--------'-------- Installation will serve: Residence I] Apartment House ❑ Commercialailer Cour}. ❑ Motel ❑ Other a❑ t ,. r&-- .ta . a' Wow a ;��O X_ 2�_ Nurnber of living units: _ -- NurribeF of s -- --- Number of• s -______,..Lot size ---- - ---- ------- -- Water Supply:' Public 'system ❑ Community-.system [g,Private ❑ Depth to�WaterSTable ._______ ft:" '� " I Character of soil to �epth of 3 feet:' Sand ❑ i Gravel ❑ Sandy Loam ❑ play Loam ❑ Clay ❑ Adobe Hardpan. Previous Application Made: Yes ❑ No,� New Construction: Yes No ❑. FNA/VA: Yes E] No, 1 TYPE OF INSTALLATION AND SPECIFICATIONS: . r 11 [No septic tank or'cesspool permitted '$ public sewer is available within 20et.) Septic Tank: Distance.from-nearest Wil- istance from foundation__fA_f".t__.Mate�al___�1"1_--------------- - :------ o' of com�pFa�tmen,ts"_ ^ - Sized(�- --- ---Liquid depth - _ Capacit _ ' fes - k Y Disposal Field: Distance from nearest well._.V fC4921 Distance from foundation_�ZP -Distance to nearest lot'i-- `--"' 1 Number of lines---------- _------ :Length of each line__-_-- �--------------Width of trench__.-_'s�- _ - - I Type of filter matena��-# Depth offilter material 1��___" __-_Total length_____�_{J ! #. f _ e Pit: Distance to nearest wel�.__ t� D.istance rom oufdation _,�'� _____. `istance to nearest�bt 7tn Number o pits- '_-`A ---- -�- material �-* C Size: Diameter--- _��--Depth__- --_ f i Distance from nearest,well-----------__----_Distance from f ""------------------- Cesspool: . tP oundation .--_Lining material -------------Q;; --------------------------------------------Liquid Capacity-----------= --------------gals. r Size: Diameter---- -"------ Depth =--------------- Distance from nearest building 1 Privy ---------- g , Distance from nearest we11_____a,_____ _ ----------------- Distance i . .�... """. r ❑ - tance to nearest lot line_.._._ - --- -- �" w \ r . _1 - - t ---------------- •�--�;- f`-------- f---`- -- - -- ---------- -• ---- 'r"afV i t ' Remodeling and/or reg airing (do scrib d------------------ ---------------- ------------- ____y - I --------- ------- ---------- ------- --•-------- ----------------------------------------------------------------- I hereby,certify that I have prepared this application and that the work will be done•in accordance with San Joaquin Bounty ordinances, State laws; and rules an tionsf the San Joaquin Local Health District. C _"._ ' [Owner and/or Contractor) Si ned --•------ ----------------------------------- [ P g -=-----•--- - - ------------------(Title)--------------7--------------------- ------------- --------- Plot Ian, showing sizeiof lot, locationf system in.relation to wells, buildings, etc., can be placed on reverse side]. k ' FOR DEPARTMENT USE ONLY I APPLICATION ACCEPTED i3Y__-- ---- DATE-------- ------------ �---- -- - ------ --- -- -- ---- -------------------------- --- I --------- / --- - - - - DATE } REVIEWEDBY-------------°--------- • ------------ -- _ -- . BUILDING PERMIT ISSUED----------------- A -------_-- -- DATE. -------- ---- Alterations and/or recommendations:-_V lir�•T�- 1 1TT-- Q.1v ----•�° ---- fti-QN1----- « TtNK�. SW_' ------ ._ �R , -ray c7t� ......�V.0-- --- A �----- a.=... _�a-RT---- -- -- - i - L__- I - -- -- ----------�1`�-------- R - - { = -Date - -= FINAL INSPEC B _ ;— - � ~-4 SAN JOAQUIN LOCAL HEALTH DISTRICT 132 Sycamore Street 814 North "C" Street 130 South American Street 300 West Oak S+rest Manteca, California Tracy, California Stockton, California Lodi, California ES--9-2M Revised 1-57 F-?-CO-