20258 - Laserfiche WebLink

Home Browse Search

FOR OFFICE,USE: ; _- -. _4 -------- ------ __ - _-' --------------------------------- APPLICATION FOR SANITATION PERMIT Permit No. ___�� .._. -- --"--- --- `' (Complete in Duplicate) a �� ;i - _.._.-...�...... This Permit Expires 1 Year From Date Issued Date 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 complionce with County Ordinance N 549. r/ '141 �C JOB ADDRESS AND LOCAT N --__- - - .._ jzp-___ �__ !f+'i.�__-. -_ ----� l S E1 ' Owner's Name ------�(_Mu-MI-nm............. ------------J_OHN---S_-0_ -�. �.� --- -- Phone-----•--------------------------•--" Address---------------- ` � •---•- t. 1 '1 -- --- -�B.---- `-- �sCI}_c-4r1I- Contractor's Name =P '-------------------------------- --- -- - -- ------------------------ - ------ •---•-r --------------------------- Phone----------------------------------- .i ; Installation will serve: Residen-ceApartment House ❑ Commercial ❑ Trailer-6earf [Motel ❑ Other ❑ I Number of living units:11/ _Number of bedrooms _-Number of baths _1__' Lot size -__/44REfl6�---------------- � a � s Water Supply: Public system ❑` Community, syst E] Private Depth to Water Table 35_ ft. Character of soil to a depth of 3tfeet: Sand Gravel ❑ Sandy Loam,❑ Clay Loalay ❑ Adobe ❑ Hardpan ' r Previous Application Made: (If yes,date-----------,--------1 No EfNew Construction; Yes P4--I"T6 ❑ FHA/VA: Yes ❑ r TYPE ..w ��.,::• ,40F INSTALLATION AND�SPECIFICATION5:� ��•� --��:a� -= -� ��- -� �'�--`�=-= � __ septic tank o-r ces ppool permitted`'if-}p- biit—sd-We Y is available witliiri 200 feet.) Septic Tank: Distance from nearest well--57 --- DiIfAce from taun ion/Q_------------Material--- Q CR T--- ------------- O . No. of compartments..:_.... ------------Size__ ----- Liquid depth.-.-jam -_____Capacity-_-" ' Disposal Field: Distance from nearest well------ Distance from foundation---/0_--.----.Distance to nearest lot line--- ❑ Number of lines--------- ------------- --------Length of each line----,%r -----------------Width of trench------Zy--------------------- � Type of filter material--_j?ocjKN___-Depth of filter material_-_ ------..Total length----- ------- } stance t earest line-___ Seepage Pit: Distance to nea wel ;� -__-__ t/�_.._._ 6,..7.._ ____._ II .. " istance o 'foundat' n- _... - Number of r------- ming m ------------- Cesspool: Distance+ €om. nearest well_________________Distance from foundation____-______--_-_...Lining material------------------------------------- , Size: Dialme ............. -- . r. ... ... Depth-------------- --- ---------- - - -- -- ------Liquid Capacity gals. Priv . Distance from nearest well___________________ y• Distance to nearest _________________________ � Distance from nearest building-------------------------------..___.__. ❑ lot line_ r �Remodeiing and/or rep,. jr (dC 5a �� - -to- -- _ .d --- --- - --------'----------------•---------- ------------------------------------------------------------ --------------------------------------------------- --------------------------------------------------------------------- - ---------=-------------�---------.----------------,--------L---------.------------------.------------ 1-11------ 1 hereby certify that I have prepared-this application and that the work will be do \ done in accordance with San Joaquin County �, , ordinances, State laws, a ru and re lations of the Joaquin Local Health District.,'. 0 (Signed)._ � e - -- - -- ---------------------------------------------(Owner and/or Contractorl g .: - � -- Tit (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). ty FOR DEPARTMENT USE`ONLY APPLICATION ACCEPTED By---------- ..__ ._ _ r ,.. DATE-_ REVIEWEDBY-----------------------------------------------------------------=----------------- ------------i----------- -------------- DATE-----------------------------------••---------------------- BUILDINGPERMIT ISSUED-----------------------------------------------------------------------------------I------------------ DATE------------------------------ ------------------------------ Alterations ---- ---------------------Alterations and/or recommendations------ -------- ----------------------------------------------------------- ---------------•-------•------------------------------------------------------- ----- ------ ----------- - --- --- ------------------------------------------ -- 1 ----------------------------------------------------------------------------------------------------- i: ' ------------------------------------------------------------------- ---------------------------------------- -----------------------------------------------------•--------------------- ------------------•------ -------- ---- ------------- - --- --- ----- - ------------------------------------------------------------------------------------------------------------------- -------E'--------- - ------ --------- - - --- --- - --- -- --------------------- --------------- ---------- -------- --- -------- ------------------------ -------------------- FINAL INSP ON BY - Date.---------- � _ `` . - ' SAN JOAQUIN LOCAL HEALTH DISTRICT d 1401 E.Hazellen Avo. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California E l5 w