Laserfiche WebLink
FOR OFFICE USE: <br /> >:---- APPLICATION FOR SANITATION PERMIT <br /> ---- ----------- -------- <br /> (Complete in Tripe <br /> Permit-No <br /> ---------- licat ) : <br /> -------------------- -------------------------------- This Permit Expires 1 Year From Date Issued Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit_to construct and install the work herein <br /> described. This application is made in compliance with County Ordinance No. 549. and existing Rules and Regulations:, i <br /> �., <br /> JOB ADDRESS/LOCATION .- --- I ___--` -VI ----- --- ---- -Ml`C_A CENSUS TRACT.r _ ,:' Owner's Name ------- <br /> -- i _ .. <br /> _ = Pone <br /> - - ------ .Ti�4' — ` '- eery h <br /> Address - - -- ---------- w) � <br /> Mrc- <br /> ------------------ <br /> Contractor's Name = Ul//1/---- -------- ------.License # y : ---------- Phone ------------------------------ <br /> Inst0`1 10h will serve: Residence ff'A"partment House'[] Commercial []Trailer Court ;[] <br /> -3 v' Motel 4 Other �"` <br /> Number of living units:__. ------ Number of bedrooms .____Garbage Grinder _AEE�5 Lot Size _:20 DDQ —4_ <br /> ----------------------- <br /> Water Supply: Public System and name _--_-- --- _ <br /> ------------ ----------------- ---- ---• - - <br /> Character of soil to a depth of 3 feet: Sand� E] _ :Private <br /> 'Sand -�.. _ pea _ Loam _ lay „ ._ _ <br /> ��.. _ Clay ❑ t -Sandy �❑ C Loam ❑to <br /> Hardpan ❑ Adobe E]„ Fill Ma#erial : - _Q Ifye <br /> ---------------- <br /> N (Pl <br /> ------- - --- <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must E e placed on reverse side.) <br /> r NEW INSTALLATION: {No septic tank or seepage pit permitted if public' sewer is available within 2001eet,) pp <br /> i <br />' PACKAGE TREATMENT [ ] SEPTIC TANK,[ ] Size_-___- ' I .,� <br /> - ------------------------------ Liquid Depth -------------------- O <br /> r <br /> Capacity P tY TY e - =_Material ------ --i_lon <br /> -- No.`,Compartments <br /> Distance to nearest: W' I -------------- -'---------------__�'Fo6ndat ---------- <br /> LINE [ ] No. of Lines _--_ Length of each .line.-- -�------ -------- Tofal Length ------ <br /> 'D' <br /> -----. . . <br /> 'D' Box -------_--- Type Fil r Material --------------------De Depth. FMaterial <br /> Distance to nearest: Wel __ _- - PropertyLine _-_Foundation =-Depth t E PIT Nymbe;-_-__ _ .----_Rock Filled Yes �❑ No i❑PAG ----------Water Table Depth ----- --------- Roek Size - <br /> Distance to nearest: Weil -----_----_ ' FoundatiProp' te---p ON{Prov. Sanitation Permit�# -___ 11---_------- ------------ , ------------------------ <br /> Septic <br /> _---__-- FPAIR AbDITIf -------- ._ <br /> Se tic Tank (Specify, Requirements) ----------------- <br /> ------------------------ ate ___._ <br /> Disposal_Field I ------------------ <br /> ---------------------- <br /> PecifY Re uirements) ----------------- <br /> ------ - ----- - 7 <br /> ----R- ` ------WI- --- c 4 <br /> N -------------------------------------- <br /> ------/5a t� A-[h �r <br />