16306 - Laserfiche WebLink

Home Browse Search

'AOR-0MCE'USE: s• Y = ---------A_1yAA______ -------------------------------- APPLICATION FOR SANITATION' PERMIT Permit No. ._ - .(Complete in Duplicate) _. Date Issued" 3, -- -�3 ----- ------ --- ----- This Permit Expires 1 Year,,.From..Date Issued Application is hereby made to the San Joaquin Local Health District for a,permit to c str ct and install the work herein described. This application is made in�mpliance with County Ordinance No. 549. 7�� KT �• i A I JOB ADDRESS AND LO ATION ---— -----FRC1 T, _��e /� _ - Owner's Name-•-----.�—A.I.V_�- -----=-------13-arT- i's7-----� URC-H------------ ---------- -- Pho-------------------------------------------------------------------------- ne_ _-- [ Phone--------------- I' Contractors Name-----fat � = ------------------------------- 1 y ----- { Installation will serv6:*Residence &artment4Hcuse ❑ Commercial'❑ Trailer Court ❑ Motel ❑ of f4URQ44 - ` .. -___-- Number of.baths _--__ p Number of living units:_- Number of.bedrooms _ Lot size _ -------- ----- .:. i Water. Supply: Public system ❑ Ca- m� tsystem ❑ Private r Depth to Water Table __ ft. ? -Int Character of soil to a depth of 3 feet: Sand Gravel C3 Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan 0 Previous Application Made: (If yes,date--------------------) No [�]� New Construction: Yes �n ❑ FHA/VA: Yes ❑ Noi ftp II. ..m_ ,. ..._ _: -_ �----T-YPE.�OF-INS-T-A-L-L-A-T-ION-AND-SPECIFIG.-A-T-10t5:-�` " '" "" r (No septic tank or cesspool permitted if public Sewer is available within 240 feet.) r I Distance from fou dation__!_ ----------- ate-riai--��Q"_��_�__�_-_�R f� ` Septic ank. y Distance from nearest well__s _.__ Liquid de th__ ��-_------_Capacity___-- - - of compartments-------2-F_____________Size_______ ��-: q P. ----- No. d t 11 1P c ? Disposal Distance from nearest ll__ -_'- Distance from fo ndtion_-- -----Distance to nearesone---� mber es_-_____ each�l"ne -/470 - Width of trench._-.-_Nu= ._ oJ . ---f -----.-_.---Ifermate -al _ ` Total leng Seepage " Pit: Distance to nearest well from fo�uundation__------___-.-__-_.Distance to nearest lot line--- ❑ Number of pits-----------------------Lining material---------- V.Size: Diameter------------------ ----Dept{n----------:-------------------'- P Distance from foundation----'--------'___--.Lining material------------------------------------- ---------- ----------------------- Cesspool: Distance from nearest well_____-__---__--:_ ; Qepth:3 ! ri .tt- Li uid Ca acit -------.gals. i. ❑° , Size: Diameter-------------- q P Y ----------- - Privy: ` ,Distance from.nearest well--_--------------------- --------- ------Distance .from nearesf Building------ _----------------- ❑ Distance to nearest lot {ins------------------------------------------------------ -------�---------_-- - ------�--•=------ -------------------------------- ------- O _ , _ # c� z Remodeling and/or repairing (describe)-- X CAPA �1. -_-_` V.- _P61_---_�� C44-- t� � 17 r . », E --------------- ---------- Z - - -- ------ ------. --- --- --- - ------------------ -------I---------- --- --- ------- = - ----------- I hereby cer+ify that I have prepared this applicat onVand tliat the'vwork will be done in accordance with San Joaquin County i ordinances a law , and rules-a d re ulations of+he San' Joaquin Local Health District. i 4�• 41 and r ---- ------- 5i ned ----- ---- -- - . ----------------------- I (Plot plan, showing size of lot, location of system in relation+o,wells, buildings, etc.; can be placed on reverse side). I! FOR DEPARTMENT USE ONLY ' APPLICATION ACCEPTED By _-O.-•---------------------- --- -------------------------------- DATE S r REVIEWED BY------------------------ ------ ------------ - DATE '-•------ -- ' BUILDING PERMIT ISSUED--------------•------- ------------------------------------------------------------------------------ DATE--------------------------------------------------------------- I --- -------------------------------------------------------- i Alterations and/or recommendations---------------------------------------------- --•------_----------=------ •--------------- ----- - - - ---------------------------- ' ""0 - "„-- - � �T _.r, � �i � -------------- -------- . ; .`6 . -- = ,. ------..._..""r� =. -------- •----------- ---- ----------- ---------- ---- -- -- _ ------------- --- ----------- -- ---- -------------- -- ---- ------ - ----- ----------------- FINAL ------------ _ ------'--- ---------------- . FINAL INSPEC u Date--Al------ ---�'='--� - - - ---� - -------------- - 46,;A.ii_j_at.SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hasellon Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California V. ES'9 REVISED 9-59 3M 3-'63 F.P.Ca. i .