4418 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit N-6. (Complete in Duplicate) Date Issued --- Application is hereby made to the San Joaquin Local Health District for a permit to construct and 4,risfthe work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION------ _0 —-- v -------- Owner's Name---------------------------------------Iletikl- Address-------------------------------------_----------- ------------------------------------------------------------------- Contractor's Name--------------------------------PAkRIS-4-------TXC--------------------------------------------------------------- Phone--- ---------- Installation will serve: Residence D!�_ Apartment House [] Commercial E] Trailer Court ❑ Motel ❑ Other E] Number of living units: _T Number of bedrooms __7YNumber of baths --/- Lot size ---—-------- Water Supply: Public system E] Community system El Private§4- Depth to Water Table _040ft. Character of soil to a depth of 3 feet: Sand E] Gravel F] Sandy Loam E] Clay Loam E] Clay E] Adobe;K Hardpan ❑ Previous Application Made: Yes L] No Qf New Construction: Yes Ej No El jRL7Fj4e_r%men-t TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted i .Publir, sewer is available within 200 feet.) Septic Tank: Distance from nearest w 51---Distance from foundation._, -;2-."---.MaferiaI----- No. of compartments------------- ---- ---Size.:,%_,'?�4"__�----Liquid depth_45--t r------------Capacif 0--- ------ CC-R,,P Y___96, - r d to nearest lot line_----_47___ 47.0�1 Disposal Field- Distance from nearest well.,5 ,T......Distance from foundation.. - --- Number oz lines-------I------- Length of eat x -----it------------ 1Q_-------------.Width of french... Type of filter material___1_Y&*'__R_k-----Depth o ria ---_11"'*......Total length___.__ i®_f__ ' Seepage ength------ Seepage Pit: Distance to nearest well-100" Dis ce from fou fln------S—r., - ------Distance to nearest lot ;ine---- ---T..... _!$ e-------Depth---ZZ7 ---------------- Number of pits----f------------------L i i g- m- i e: Diameter-A Cesspool: Distance from nearest well-________________ nce fro fo aflon--------------------Lining material________,______________._._-___-... Dep- 0 is IJ Size; Diameter--------------------------------------Depth-------------------------------- ------------------Liquid Capacity- - ------------------------gals. Privy: Distance from nearest well-________.._-_______._____________ __________Distance from nearest building------------------------------------i------ ElDistance to nearest lot line----------------- ---- --------------- --------------- - ---------------_----------- -------------- ---------------------------- ; Remodeling and/or repairing (describe)------------------------------------------------- ---------(0-7-b2:70. 7 ---------............ -------------------------------------------------------------------------------------------------------------------------------------------- ----------------- -------- -----------------------I-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------- ----- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---- ------- I hereby rtif that I hav prepared f"i I application and that the work will be done in accordance with San Joaquin County ordinances. St to I s, a r I and regul Ins of the San Joaquin Local H Ifh District. (Signed)--------- --- --------- ------------ - --- ------- --- ---------------------------------- ------jQp%*m=bP4lp4M Contractor) By:--------------_------------------------------------------------------------------ illm 10-112----------- -A' -------(Title) (Plot plan, showing size of lot, location of system in relatiolo�wLelli,, buildings,11c., can be placed on reverse side). FOR DE ARTIVIENT USE ONLY _5b -- -------- APPLICATION ACCEPTED BY ---------------------------------------------------------------------------------- DATE_f:::�-------- --------------------------- ----------------- REVIEWED BY------------- ------------------ -- -------------------------- DATE-_-'�'.'---------- BUILDING PERMIT ISSUED---------------------------------------------------__----------------------------------------------- DATE------- Alterations ATE-------Alterations and/or recommendations------------------------------------------------------------------------------------------------------ ------ --------------------------------------------------- -----------------------------------------------------------I-------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------I--------------------------------------- ---------__------ ------------------------------------------------------------------------------------ - ---------------------------------------------------------------- ---------------------------------------------- ----------------------- --------------•---------------------------------------------- ------------------------------------------------------------------------------------- -----I------------------------ ----------------------------------------------------- ---- - ----------------------------------------------------------------------------------------------- -------------------------------- FINAL INSPECTION BY---------------- --- ------ ------------- Date----- 7v 4 / ----------------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California E5-9-2M 10-52 Revised W-2100