20563 - Laserfiche WebLink

Home Browse Search

7R OFFICE USE: s � s�� `APPLICATION FOR SANITATION PERMIT Permit No. -- --- -- --- ------------------------------------- ..................... . ---------------------- --------------- - ---- ------ (Complete in Duplicate) --------------------------------------- ------------- This Permit Expires l Year From Date Issued Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and in a work herein descrbed. This application is made in compliance with County Ord nce No 49. r JOB ADDRESS A C kON___ _ _&.0. --- - -- ----- ---- - ----- ----- ______________ Ph —Go,Name--- - ----• ---- y_____ ___ ----------- ___________________________ -- Y Address t ` - ----- ------•----- -- --- ------- --------------------------------- ------- ------------ Contractor's _ ----- .-.. Contractor'sName � dv - ----- -F---------------------------------- Phon - Installation will serve: Residence A artmdnt House Commercial Trailer Court El MotelF Other El Number of living units: _-_�__ her of bedrooms =-�_ Number of baths ----/_ Lot size __WST__.-_�_ c-_`3'-. ----_-_-_Water Supply: Public system Community system ElPrivate E] Depth to Water Table . Character of soil to a depth of 3 feet! Sand ❑ Gravel [❑ Sandy Loam ❑ Clay Loam ❑ Clay Adobe Hardpan ❑ Previous Application Made: (If yes,date--------------------) No ❑ New Construction: Yes ❑ No FHA/VA: Yes ❑ No ❑ i TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) S is ank: Distance from nearest well.----------------Distance from foundation--------------------Material-------------------------------------_.._._-_._. t No. of compartments--------------------------Size__-------------------------Liquid depth----------- - -- -------- Capacity----------------------- il Distance from nearest well_�rrw.i.&,Distance from foundation--_.�--.0_ _.Distance to nearest lot`l�ine �� C �l'"y Number of lines__:_ .__ _ Length of each line` )_ �o �J r ----- 0 9 0--------------Width of trench--p e-y 4 1 Type of filter matenai Qp a � Depth of filter material-_-__/,F _ g 11 -Total length --------- Q -------- Seepage Pit: Distance to nearest well-l4.Q_(�L,eDistance from f`oundation___ 0�Distanc`to nearest tNumber of pits___- ________--_.-_Lining material---R-Ct:_CI__.Size: Diameter__�p�._ ___.Depth-_-.. .-_-_._--__.._ Cesspool: Distance from nearest welf-----------------Distance from ndation.-___._____._____...Lining material_.____..._.___-_.____._______._._ ❑ Size: Diameter------ ---------------------- ------Depth------- ---------- ------- ------------------Liquid Capacity------.-------------------gals. Privy: Distance from nearest well__,___.__.------------------------- ----------Distance from nearest building---------------------------------------- ❑ Distance to nearest lot line-------------------------------------------- - ------------------------- ------- ------------------------------ - -- . Remodeling and/or repairing (descri.be}---------------------- ---------------------- -- --------- --- --- ----- -- --} ----- ----- - --- -- ---- --------------------------•--- ---------------------------------r -------------------------- - ------- -------=------------------------------`------------------------- --------------------------------- ---------------------------------------- --- ---------------------------------- ----- •� ----------------------------------- 1 hereby certify that ] have prepared this appli' at i nd that the work wi! be done in accordance with San Joaquin County ordinances, State laws, rules and regulations of a Sa Joaquin Lo 1 H !th District. .IJa �� Vf,,4je Li -- ---------------------------- ------- ---- --- ontractor (Signed} fApAt 1 ) �KPTIC TANK SE*RVId-k -(Title)--------_--------_._ _ By:- 915 E.-ilhiner Ave:; - ------------------------ ------------------- --------- (Plot plan, showing size of lot, location of system inldi etc., can be placed on reverse side]. ,i F& DEPARTMENT USE bNLY APPLICATION ACCEPTED BY_ � -------- -- ---------------------------------------- DATE----5-1-S-16-1 REVIEWED BY------------------------- -- --------- --------------------------------------- -- ---------------------------------------- DATE------ ------------------------------------ ---------------- BUILDING PERMIT ISSUED -- --------------------- - - --------------- DATE------- ----------------------------------- ----------------- Alterations and/or recommendations:1------------------- --- --------- ------ ------------------------I------------- - -------------------•------ ------------------------- ---------------- ------------- ------ ---- -------------- -----------------:------------------------------------------------------------------------------------------------••----------------•----------- --------------------------- ---------------------------------- ------------------------------- ------------------- ---------# ---------•----------------------------------------------------•----------------------------------------------------------------------- I -- - ------ - ------------------------------------------------------------------------------- ------------------------------------------------------ -- - ------ ----------------- --- ------ ------ ---------- --------------------------------------- -------- ---- ----•- ---- ---------------------------------------------------------------------------------------------•-- ---------------------- --------------------- FINAL -------------- -----FINAL INSPECTION BY:- 'f.:._':.. -------------------- Date.--- �� SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Haselion Ave. 300 West Oak Street 124 Sycamore Street 205 West 9Th Street Stockton,California Lodi,California Manteca,California Tracy,California F.P.CO.