6303 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. ------ ...3.?..__..... (Complete in Duplicate) II�yy//� Date Issued .___.____Ils.__..-- Applica{ion 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. JOB ADDRESS AND LOCATION ffCX 756 Porter Avenue, Stockton Herb Patton ---------------------------- ---------------------------------------------------------------------------------------------------- GRACE LUTHERMT CHURCH Phone----_HO_--'7375------- Owner's Name--------------------------- ----------------------------------••-•-•-------------------- ---- ------------------------------------------------------ Phone------------------------------------ Same -------- -------------------------------- Same Address........---------------•------------- ---------------------------.._..------------------------------------.._...----------•------------------------:------ -------- --------------------------- ....... PARRISH INC. HO 69607 Contractor's Name... Phone------------------------------•---- Installation will serve: Residence PC Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: 1..--- Number of bedrooms ------ . Number of baths _ ____ Lot size ------O4er-_.1 2'Cre_____________________ Water Supply: Public system ❑ Community system ❑ Private.;] Depth to Water Table -------- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe [N Hardpan ❑ Previous Application Made: Yes)A) No 9 New Construction: Yes M No E]' TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public seweygsavailable within 200 feet.) t f Septic Tank: Distance from nearest well__.. 50---___�ista fro u on-_____10_______-M t r�iaLCC B ' .� ] No. of compartments_....2.. ------ ��X 6 X �j 1 40 Gals. 0---------SiSiiu�---------�- ---------•---Liquid CapButY-------=--------------- 501 -----�0-�• t Disposal Field: . Distance from nearest well. ------�istance from foundation_______*_____._._.Distance to nearest lot lin _______ ____ KK Number of lines-_--__ �`___ ------ Width jA: of filter material_.-1.8� _.-Total length______120 --------------------- Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to neaeJ lot line__.__..._________ ❑ Number of pits----------------------Lining material---.------------------.Size: Diameter-----------------------Depth..-.--.------------------------- Cesspool: Distance from nearest well-----------------Distance from foundation------------------- Lining material---_------.----------------.-__-_____. ❑ Size: Diameter--------------------------- .....--..Depth------------------------------------- -----Liquid Capacity----------------------------gals. Privy: Distance from nearest well ___________________-____-____.- --------------Distance from nearest building---------------.---__.________-..-.__-_-_. '\ ❑ Distance to nearest lot line---------------------- ------•------------------------------ ._....- ry Remodeling and/or repairing (describe):-,_.... ----------------------I-- T ---- - -•---------•--------•-----------•---------------•--------------•-- ------------------------------•--•--••----------- ------------------•----------------------------------------------•---•-------•---------•-•-----------------..__....------------ ----------------------------------------------•-------- -----------.---------- -------------------------------------------------__________________________________________________________________________________________________________________________________________________4_..-----_--_______.___.._ 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 f the S� Joaquin ocal Health District. PARRISH INC . /.-_._- -__-- - _ _ Contractor (Signed)---------------------- • -------------------------------------------- :��------- --- -�---- - -- - - � - -------- ------ ------------------ �/ / ESTIMATOR By--------- -----------------------------------•--------------------- ---- ------(e ta, ----- {Title) ------------------------------------------------ (Plot plan, showing size of lot, location of system in relation to wells, build* /�s, e+c., can be placed on reverse side). V FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--- DATE------ _._-_____.._________________________________ REVIEWEDBY------------------------------- - - - ---------------------------- DATE----- -----... - -- BUILDINGPERMIT ISSUED------------------------------------------------------- ---------------------------------------------- DATE.-------------------- � 5 - - Alterationsand/or recommend a+ions---------------------- ------- --- ----------------------------------------------------------•------------•---------------------------------------------------- --------------------------------------------------------- -- -•-------------------------•-----------------------------•-•-----------------•• -•-----------------------------------------------------•--------------------- -----•------=-------------------------------- ----------- --------------------------------•-------------------•---------•------------- -----------------------------------------•-----•--- FINAL INSPECTION BY:-------- - ----• ---------- - ----•--... Date..------- -----------•- --•------ 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 Es-9-2M *45446 PTWUOD 17.54