68-193 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: --------------------------------------------------------- APPLICATION FOR SANITATION PERMIT Permit No. ..��_.r�:.Z 13 ----------- ---------- --------- - ----------------- (Complete in Duplicate) Date Issued ----------------------------------- IThis Permit Expires 1 Year From Date Issued Application is hereby mgde to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with Country Ordinance No. 549. r JOB ADDRESS AND LOCATION �08.I. �G... ---------------------------------------S.�il' 'QT lk�A,Y: �NTffl Cc..y__p ,l�9_'>r :- y -- -------------------•------------ ---- Phone' `' � (�a � Owner's Name-----___. Address----------------- 3 'P-----------JOAN-------- E.S-------419-N E--...------ . ... Contractor's Name----` IEKD RN-------------------------------------------------------------- -------------------------------------------------- Phone----------------------------------- Installation will serve: Residence [Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ---I---- Number of bedrooms A_. Number of baths _�__. Lot size -./0-Ce-4-----------_-------------------- Water Supply: Public system ❑ Community system ❑ Private [Depth to Water Table .--__ ft. I Character of soil to a depth of 3 feet: Sand g?"Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ Previous Application Made: (if yes,date______ ----------) No Igo New Construction: Yes ' No ❑ FHA/VA: Yes ❑ No TYPE OF INSTALLATION AND SPECIFICATIONS: �\ (No septic tank or cesspool permitted if public sewer is available within 200 feet.) If Septic Tank: Distance from nearest well__V0- Distance from fou ation_./Q..._--__--.Mat rial_CtAA ______________________ No. of compartments k gl_ C?U-tiilruipth Capacity 1 4 s ante fyotm tun w,�- f Disposal Field: Distance from nearest well.7Q----___.. r" f dation__l.�iF____..__._.Distance to nearest lot line Number of lines_-_._ f f` ❑ .,�________________________Length of each line_��______._..______....Width of trench,,.��___:-------.._.______.__ Type of filter mate riaL�T1�CA '.Depth of filter material---/Q_°11-___--__Total length_-/,��---------------------------- Seepage Pit: Distance to nearest well----------------------Distance from foundation----------.---------Distance to nearest lot line_--___.--____-.-_ ! El Number of pits.-----------------_---Lining material----- ---....:---------Size: Diameter------------._-.-------Dept h---------.._____________________ Cesspool: Distance from nearest well-----------------Distance from foundation------__.----------Lining material______-.-__:_._--_.___--_--_--_. ❑ Size: Diameter-.__ ------------------------------Depth-.--------------------------------------------------Liquid Capacity----------------------------gals. Privy: Distance from nearest well --___--..----------------------------------.__Distance from nearest building______________--__._..-____---.--____. ❑ Distance to nearest lot line-------- •---------------------------------------------------------•----------•--------------------------------------------------------- Remodeling -----------------------------------Re g n or �� des i ): {- ` 7 .�.��Q T� ------------------------- ---------- ----------------------------------------------------------------------------------------------------•----------------------------------------------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with-San Joaquin County ordinances, at aw , and ru s and r ulations of the San Joaquin Local Health District. (Signed) = QsL(� = = -fawner and/or Contractor) By------------------------------------------------ ----------------------------------------------------------7_.9 '--(Title) - (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY----- --- ----------------------------------------------------- DATE------ _."�. .�_ .------------------- REVIEWEDBY------------------------_ ------------------- ---------------------------------------------------------------------------.-. DATE-------- --------------------------------------------------- BUILDINGPERMIT ISSUED-------------------------------------------------------------------------------- ------------------- DATE-----.-.- -------------------------------------------------- Alterations and/or recommendations:- ------ ------ ------- ----- -------- ---------------------------------- ------------------ ------------- ----------------------- ----------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ --- --=------------------------------I--------- -------------------------------------*------- ...-_----.------ -------------- ---------------- -------- - ----- --- - - FINAL INSPECTIO 4`. ... __ __ Date-__ '_ .-`�� SAN JOAQUIN LOCAL HEALTH DISTRICT 140t.1.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California F.P.CC.