9983 - Laserfiche WebLink

Metadata

Thumbnails

Annotations

J APPLICATION FOR SANITATION PERMIT Permit No. _1..�__---- (Complete in Duplicate) 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 compliance with County Ordinance No. 549. f 2136 O ,108 ADDRESS AND LOCATION =------ - - - --- ---- -----------------------------------•------------------------------------•- ---------------=----------------------- Owner's ------- -•-------------Owner's Name - - -— ---Ko - -------------------------------•__1---------------------------------------------------------- ------------- Phone)0--4--6402----- Address--------------------------211 North Sen Joaquin Street -----------••--•-------------------•-------------------------•---------------------------------.._.-- .-.----- Contractor's Name----- --- c-_-5-oras---- - PhoneHO..6_-9607 -------------- ---------------- Installation will serve: Residence K] Apartment House ❑ Commercial .❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: A---- Number of bedrooms ---2_ Number of baths __I--_ Lot size -------50-1XI20_1______________________________ Water Supply: Public system ® Commuriity system ❑ Private ❑ Depth'to Water Table _451 ft. Character of soil to a depth of 3 feet: Sand [I Gravel ❑ .Sandy Loam ❑ Clay Loam ❑ Clay [] Adobe:[j Hardpan ❑ Previous Application Made: Yes ❑;I No ® 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.) Septic Tank: Distance from nearest well-----------------Distance from foundation---------------------Material ________________________________: ___._______.. EXI�Sting No. of.compartments---- -------------------Size---------------------------------Liquid depth--------------------------Capacity...-------------•- Disposal Field: Distarice from nearest wefi-------------------Distance from foundation----------------.....Distance to nearest lotline_______--.___-__ { ExMsting . Number of lines------------------------------------Length of each. line------------------------------Width of trench--_-------------------------- -_-- Type of filter material-_______________________Depth of filter material___- ------------Total length---------------------------- Seepage _______.___ __________-___Seepage Pit: Distance to nearest we_ILN_0_ W_el].Distance from foundation---25-_.........Distance to nearest loft line__101_______ ® Number of pits---l_1---------------Lining material---ROCk--------size: Diameter---------3'3_--_.___.Depth------Z5..................... Cesspool: Distance from nearest well-----------------Distance from foundation ____ Lining material__.._____...___._____-____--______.__. \ ❑ 41 Size: Diameter__.._l-------------------------------De th----------------------------------------------------- pLiquid CapaatY--------- --------------•--gals. Privy; Distance from nearest well--------------------------------------------------Distance from nearest building----------------_--------------------- ❑ Distance to nearest lot line--------------------------------------------------------= - -' t Remodelin and or repairing (describe g / re ap g (di ):---- --- ---------------------------------=------------ --------------- •------------•- k --------------------•-----------------•--------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------- i ----------------------------------------------------------•--------=--=----•----------•-•- ---------------•-----------------•--------------•--------------------------------- ---------•------------------------•------- i I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. D•A• Parrish & Sons lnc . (Signed)-.- -------------------------------------- - -- {Owner and/or Contractor} r By:----------------- UI_NxAzlht----------------------------------------------------------------------------------(Title)----- st-+--------------------------------------------- , (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). a, FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ------------------------------------------------------- DATE-- ---•----------•------------ REVIEWEDBY------------------------------------- ----------------------------------------- -------------------------------------- DATE----------------------- BUILDING PERMIT-ISSUED----------------- ------------------------------------------------------------------------------------ DATE--------------- Alterations and/or recomm dations:E. -/ � ' "�� `* ------------------ ---•--------------••---------------------------------------------..------- ---------------------------------------------------------------- ----•---------------------------------------------------------------------------------------------------------•------------•-------•-------------•------•- ------------------------------------ --------------------------- ,�.. -- - - ---------------- =------------- -- J =M --'------------)---•----------------------------- -------------- -•-•-------- y FINAL INSPECTION BY:. = ----------------------------------- Date-----------------------------w ` r r" ---------------------- SAN ------------SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street ! 300 West Oak Street 132 Sycamore Street 814 !North "C" Street Stockton, California t Lodi, California Mantace, California Tracy, California ES-9-2M , Reviseo 1.57 F.P.CO.