Laserfiche WebLink
APPLICATION FOR SANITATION PERMIT Permit No. <br /> y���p��� m uup/�arm <br /> ' Dote Issued <br /> `J Application�- <br /> hereby made to 6 �' -nJoaquin- Local- Health- --ricf- - - permit- to construct - -- <br /> - - -Tall the work- herein described. <br /> This ml�ot� is ' <br /> / ''-' <br /> . Phone_ '''__._--_-''--- <br /> - �-_.' -_.'--'_--_'-'_-__ � <br /> Con*oc+o�o Noma-.-� .-''�-' ---_-.. Phone----------------------------------- <br /> Installation <br /> _--_-_-_. <br /> |n`ta|lationvill serve: Residence 2T-_�A_parfmenfHouse L] ColAnial Trailer Court [] Motel E]� Other �� <br /> Number ofliving units: j-.. Number ofbedrooms Number of 6uf6s -------- Lot size -------___---------- � <br /> Water Supply: Public system ;?T'�Comm- system'E] Private rl Depth to Water Table -------- ft. <br /> Character of soil to a J����� � � ��, �n6 � ���| [� �o�y Loam � Clay L�� [] Clay /� o��n [] <br /> �- --��" � � � <br /> Previous Application Made: Yes [] No [] New Construction: Yo, F] No El FHA/VA. Yes El No [] ' <br /> TYPE OFINSTALLATION AND SPECIFICATIONS: <br /> (No septic tank mr`cesspoo| permitted |fpublic sewer isavailable within 20Ofef) ` <br /> Septic Tank: Distance from nearest <br /> we�-- -'U f ion .�� ..Material---- � ' <br /> ' - -�~- <br /> / <br /> �No. ofcompm/+men+s. Si�o � � \.. �`�' quiJ 6epfk- .------Capacity.- � ���-. <br /> / ~ ~Distance ^ �{| Field: Distance 6n � ~ from foundation / ` <br /> D <br /> ---------- <br /> Number of |iLength of each | offrench---� <br /> LiL <br /> - � �Typo of filter maforioL' h of filter mo+o,inL..���1 �.--Total <br /> length--ld-------------------------------- Lw <br /> / <br /> � � ----------- <br /> Seepage Pit D�+once to wu| � D�+ nca +q | | � <br /> ^ <br /> Numbnr of pit,-..IL----.Lining ma+oriu|� �� ---�5�zo: , <br /> Dio�ofec.�����-----Oep+h-.��t�L----.- <br /> Cesspool: Distance from nearest ~vU_----D��anco from foun6u�on-----_�ning motu,oL------�--_�----- � <br /> El Size: Diameter-------------------------------------- ----------------------------------------------------Liquid Capacity----------------------------gals. ~~' <br /> ^ <br /> Privy: D�1 nce f�,m nearest weU~- ------------ ----'_-'��''�� - -Distpnc: 6om nearest building------------------------------------------ MN <br /> 171 O;stonm, fo nearest lot line-------------------------------------------------._-__-----'-_----_.--.---_---.. <br /> 'Romodeling and' <br /> n,p�iring ��uz��\!' --- '_-'_---__-___- <br /> -------'-------'-''--------'-^--'-------------'--------------'----'--'---'-'--- <br /> . ' ^ <br /> ���_�_���---~_������---------------------------------------------------------------__�����------------------------------------------------------------------------------------------ <br /> -------------------------------------------------------- ---'--_-''-_---'_-'''_-_--'''''---_.'-''--��-'_-_--_.'-_-_-''-'''-''� � <br /> | h huve pnq,anaJ this applicationatthe wor will be done'in accordance with San Joaquin County <br /> ordinances. State ie"s, and m|oy and n*gu|aMono of the San Joaquin Local Hou|t6 District. <br /> 0�no6i-��----. .�. --------_-�---_����_--.-'---���__- and/or Contractor) <br /> ` ~ ^ y \ « ' - ` ' ' <br /> By:^-'-----...... .................. ' ------------------------------------------------------------------------------r' e----------------------------------------'---- <br /> (Plot plan, showing size of lot. location of system in relation to wells, buildings, etc.. can be placed on reverse side). � | <br /> � <br /> FOHEPARTMENT USE ONLY <br /> � <br /> � <br /> � <br /> APPLICATION ACCEPTED BY------ ------------------------------------ DATE'-l3 1. <br /> REVIEWED BY--------------------------------------------- '-''''_---------------------------------------------------------------- DATE'''-! <br /> ------------------- '--------------------------- - <br /> BUILDING PERMIT ISSUED----------------------------- ---------------------------------------------------------------------- DATE------------------------------------------------_____ <br /> A|foru+|onuan6/o, n000mmnn6ationo:------.---------.---------------.-_--__.-.----_--.---..-------_--.. ~ <br /> ----_--_'-___---_-�- <br /> — '7 -~- �-=~"-' ------`�-��-��,�`' --'- <br /> ._-'_-'__--=~^�, ---__-_-_' ----- <br /> ------- <br /> -'-------------'-' ----'---'-''~''-r--'--- <br /> FINAL INSPECTION BY:-'--------'-----''- ` --L - Dofo-.,{' ------------------------------------------ <br /> SAN <br /> ''_'-'-''-''-''_S/\N JOAQU|N LOCAL LTH DISTRICT <br /> /30 South American Street 300 West Oak Street /32 Sycamore Street n|w worth ^C' Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br />