71-004 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ppPLICA;ION FOR SANITATION PERMIT Permit No. ------------ -------------------------- - ' (Complete in Triplicate) Date Issued �- --=�--- ------------------- -- ----------- -------- This Permit Expires 1 Year From Date issue . ---- ------ ---------- ifih County Ordinance No. 549 and a 'stin R les and Regulations: / Application is hereby made to the San Joaquin Local District for a permit to construct agnd�insta�l the work stein App application is made in compliance L.��/ � � described. This app ' CENSUS TRACT _-S 7, --- - ---- p7. . JOB ADDRESS/LOCATION .__-/i--- ,�-9 _Phone --- I K b-I1--6`�l --------------------------------------------- / Owner's Name ---- II�S'� Cit :58�'jbGx✓ Address . o� � G _l 1 1 Phone _k�3�5 7-3- License - / Contractor's Name ------- E Installation will serve: Residence ❑ Apartment House�Q CommercialQTrailer.�ert `�� II ---------------------- Motes ❑OtherC/ _ ------------ k 2 Garbage Grinder ---_-- ---- Lot Sze - -- """""- Number of living units:.-._]------ Number of bedrooms __- -__- -__ F: i -------Private [ ' ------------- - I ! Peat❑ '` Sandy Loam Clay Loam ❑ Water Supply: Public System and name.--__---------------- --------------- "" r '..Silt: Clay ❑ ,. Character of soil #o a depth of 3 feet.. + Sand'Q� ❑ _ Fill Material ............ if yes,type ---------- ----------- - ,: Hardpan ❑ Adobe'❑ of lot,�loca#ion of system in tat to wells, buildings, etc. must be placed on reverse side.! {plot plan, showing size t NEW INSTALLATION: (No septic tank or seep pit permitted if public sewer is available within 20d feet,)//�� SEPTIC TANK' SizefS"Y16 ---- Liquid Depth 7 Z PACKAGE TREATMENT [ 7. _ No. Compartments • 4 -- --ova Material ------ - / Capacity,/-�tiO-Q Type t /_�...---- --- Prop. Line ----4F------------- �"-_-"_"_-"________"._Foundation --_ istancet to nearest: Weil _--____ _-- i Total Leng#� LEACHING LINE t�o. of`Lines �---------------- Length of each line--__-7t?- -- - D' Box - Type Filter Material �4 j�-----Depth Filter Material f +;'= """" " 10 ,_C--—- ----- Property Line. ---g--------N� Distance to nearest: Well ------ ._--"-------� Foundation -_-- - , Diameter _ __1__-- Number r! -- ____ Rock,Filled Yes (� -- SEEP� AST Depth C — I 7 _ ---- - -- -- •--•--------•-----Rock Size _-� -�-------- ---- _� Water Table Depth __ --- aProp. Line {`a --- Distance to nearest: Well ------------ --- --- ---------------Foundation ) ti Date ---------------------------------- (Prev.REPA1RlADDITION Sanitation Permit# ------ Septic Tank (Specify Requirementsy f!f ----------- Disposal Field (Specify Requirements) _ -----------------------------"_---_---_-____-_- ------------------------------------------------------------ --------- ------------------------= v _ _.:: -- - -----'--J-�"-�" " --f�� r � (Draw existing and required addition on reverse side) l prepared this application and that the work will be done in accordance with San Joaquin I hereby certify that I have p ,p County Ordinances, State laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or icen- sed agents signature certifies the following: erson in such manner "1 certify that in the performance of the work for which this permit is issued, I shall not employ any p as to become subject to Workma 's Compensation laws of California." Owner Signed ----- ----- - --- ----- --- ----- ----- ----- ---- ------ ----- ------------ CCIA ------- Title ------------------ ------------------------- 6 (If other than owner FOR .DEPARTMENT USE ONLY /2 , DATE ---- ----- ----- ---•- ---- ---------- j11-90----------------------------------- --------------- DATE _._ -------•-- APPLICATION ACCEPTED BY -_--— BUILDING PERMIT ISSUED ------------------- ADDITIONAL COMMENTS ---- -- ------- - ----- ---------------------------------- ------ -- --------- --- ' --------- -- --- --------- - ------------------- ---- -------- -- - --- - - -Q - _ - ------------------------- - ------ -------------------------- -✓ ----------_ ------------ ---- - --- --- - ----- -- - - • �--- ---- ------ ------- ------ ----Date ---- ---- ----- ------ ------------------ Final Inspection SAN JOAQUIN LOCAL HEALTH DISTRICT F H- 9 1-'68 Rev. 5M -