18737 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: 1 _. . . ----------- ----------------- ------------ APPLICATION FOR SANITATION PERMIT Permit No. . ._. .- -------------------------- ------ ------- ---- - --------- (Complete in Duplicate) Date Issued ____ ;---�-• This Permit Expires 1 Year From Date Issue Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. M7"C-� S D�compliance with County Ordinance No. 549. x � _3 IZZo : + w This application is NaD LOCATIONde in .�_ _L -< JOB ADDRESS A " �� // 1 Owners Name--------------- �. rt}[1[ _I:_ _ �—�.� ( }-._ _ Phone------------------------------------ ------------ Owner's 4___ _��C___.____1�__'`�-------------------+ f ___--_.------_-.-._---_--.-_---.-____-_--_-------____-_.---.---_.._-_-----_.-_---.._--.__..__..__.. Address___________ ______ ` ---- -- -- - -------------------------•--- ------------•--- Phone----------------------------------- Installation Name---�-R�-- -�Qnls'P.•-_-�_`-------- -------------- - - Comme�cial Trailer cCou [�Motel ❑ Other El ❑ Installation will serve: Residence ❑ Apartment House ❑ ❑ ®3---�---17- 1---------•- , Number of living units: _�-._ Number of bedrooms __Number of baths -�t..r of size __._._._. Water Supply: Public system ❑ Community system ❑ Privae Depth to Water enable - ft' Adobe ❑ Hardpan ❑ Character of soil to a depth of 3 feet: Sand ravel ❑ Sand' ❑ Clay Loa ❑ Y ❑ Previous Application Made:-(If yes,date---------- ---------1 No,� ew`Construction: Yes Cis ❑ FHA/VA: Yes ❑ No 20"� , —TYPE-OF AND"SPECIFICATIONS: I (No septic tank or cesspool permitted if"public sewer is available within 200 feet.) Septic Tank: Distance from nearest well___ -'`-Distance from foundation_-. -�----...Mater al____cvNC- - UCS---_ X s_• Ca acct 2' 4Size--�Y• Liquid depth _..2� P Y No. of compartments------------- - -. . Disposal Field: Distance from nearest well_ ....'.DistariceL from fo• n_.-.1 i->----=-.Distance to nearest lot line_`.____ - °r . — s� .Width of trench..--- --� Number of lines_______------ -------------Length ojZ f each i ----- -- Type of filter material____ O_C-jai----Depth of';ilter material__,_. . _._-- Total length_;,_- -- -------- ` �e N I f ` ' '�. See a e Pit: Distance to nearest lwell_-'- ------------------Distance from foundation________________ -Distance to�nearest lot line-___.-.---------- Seepage ..__._._ p g Number of pits -400 I . Lining material......... - -------Size: Diameter-1--------------- -----Depth--------- ---------------------- ❑ r I f � � ' I Cesspool' Distance from nearest well-.------__- -.Distance from foundation____________________Lining material.-.._______.-__._.___-.____..__.-__ Size: Diameter---.y�J��4- -ti------- --- ---Depth-- I-------}- ------ --- ----- ----- Liquid Capacity gals. fiT ❑ _-------------Distance from nearest building-_ Privy: a Distance from nearest.well:-_------------------------------ x• .-rte: ----- -------------------------- o - 1 ❑ Distance t �nearest;lot line- --_---.- , ' --- ---------- ---- # s ti Remodeiing and/or repainng describe)-------- hjyD.1T------C �.11{� _ - /_ Cc TI= --------------------------------------'---'---------------!-------------------------------------0i i 1 -4 --------------------------------------------------------------------------------------------- ------- ------------------ 1 hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, ate laws, and rules andregulation the San Joaquin Local Health District. �. ---� -� Owner and/or Contractor ------ ---- - - --------- -- • {Title]. -� =�� BY - ----------------------------------------------------- ----------------------- ----------------------------------- i (Plot plan, showing size of lot, location of system in relation to.wells, buildings, etc., can be placed on reverse side).; � JF FOR DEPARTMENT USE ONLY O ' aQ_ ___ _________ ___________- _----------------------- DATE ._- `� APPLICATION ACCEPTED BY_�- r `---------- __ REVIEWED BY------------------- ---•--------------------- --------------- ---- - = DATE - / DATE---------------------------------------------- -------------- BUILDING PERMIT ISSUED------------------ -6.00 - - I ''� ------------------------------------------------------------ Alterations and/or recommendations��,r ----------------- ----------- ---------------------- + -------•--•- ----•---------- --------- -------------------------------------------- ----------------------------- ----------------- ------------------------------------------ +" � a t- ---------------a .a s • . ---' e --------------------- E ...... .......... ..........•------ ----- / Date--- f FINAL INSP ION Brno --- - --- ---------�--P--- --/-� - �'--(Y -- ---------'--- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Haselton Ave. 3oo West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California F.P.CO.