68-129 - Laserfiche WebLink

Home Browse Search

f-UN OFFICE USE: -------------------- ------ APPLICATION AOR SANITATION PERMIT Permit - --- ----- ---------------------.-- --------- (Cornplefe•in Duplicates al -.-.--- This Permit Ex ires�,Ye�r From Date issued Date issued Application is hereby made to the San Joaquin Local Healfh DistricAor a perrsi�`if to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. tc� s� • JOB ADDRESS AND LOCATION------ -1 _ :.___.__ .-: '-- '` � r R -r - � FLQ ---•-- -o'rtA RD. Owners Name--------E-se-A o-AV---------i5Pos_Ts,M_A +�� .�' Phone. Q� �; `--' - Address._____,Ct�-_____Q/LL ST} QT3r - ----------1 rI�----- C'C)L��`. � ----- 7--�-------•----. 1 Contractor's Name.Ql[!(11V �-----------•-------••-- ------------ - �- I. ----_---- `--------------- Pho4F----•----------------•--•--------- Installation will serve: Residence ❑ Apartment House CommercialTrailer Court $ ❑ ❑ � ❑n Mote! ❑ Other ,fuPP livingnits: _�___ Numb er of bedrooms __._____ Numbs of baths 'i Lot si . __RcEA . "*. _ -------------------- } Water Su I 1 PPublic system Com unity syste ❑ Private.�e ep} tto Water TabI i7S_ ft Character of soil to a dep}l1 of 3 feet Sand Gravel Sand Loam Cla oam Cla Adobe ` 5ardpan �� ew Cons'�uc+io`n,y siVo ❑ ❑FHA/VA: Yes No ❑ Previous Application Made: (If yes date___.___..___._ l No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: s (No ssepflc fanli dr cesspool,permitted if public sewer is available within 200 feet.) Septic Ta �i�ista�nce from nearest well__.__._ ......Distance from foundation �y�.hrlat erial CQIVC E-- - _- Size._ ._ .`Y s�:'��tt� a�om�partments_.._-'�;._ �f•X1Q,- -. _ _Liquid depih ��Zr,_ Capacity---- -f----- --------- Disposal .isld: Distance from nearest well_-. _.-.-Distance from foundation_ _ t..asfance to nearest lot line__--------------- 1 __________ 9 Number of lines ----------_�Z�-__---_____Len th of each line__..: idth of trench------ f I Jf------------i Type of filter materiaV.__3Q-GK.---Depth of filter material_..._P7......------Total length_____...__.-----/2-P-_ See page`Pit':---Distanci't% nearest vwell----------------------Distancefrom foundation__________ ---------Di tante to nearest lot line------:`--------- \ ! ❑ Number of pits-_-------------------Lining material- _ t------------- Depth----------.-"--_ _--. ._._------.. Size: Diameter---.----- ------ Cesspool: Distance from nearest well ------ ---------Distance from foundation................. . Liming material----------- __ ❑ Size: Diameter Depth - Liquid Capacity ----gals. Privy: Distance from nearest well------------------------ --------- from from nearesat buil'dine__-.---__-----------_-- _- ' ❑ Distance to nearest lot line y`� 1F Remode#Ing and/or repairing (describfe)s-_.._-___._.__. l ------- Le - - ------------------------------------ ------- I --------------------•-------------------�--------------------i-----------•---- .:------- ----------------'--------------------:' - � k *,II -------------------------- ------------------------ .. ----"s y---��---�------------- ------- - I hereby certify that )Whave pr p ed`fWjapplica+ion and that the work will be done in accordance wifY.San Joaquin County ordinances, State laws, and rules and-fregulations of the San Joaquin Local Health .District. �. 3 + i (Signed)-• ---- - _..._:(Owner and/oraContractor) i B -------- --- - -- - - - ---------- - -- (Title) �'' ---------- -- - Pot-plan;-showin size-of-lot,-location- sys+em in relation-to-wells,-buildings;etc: can`be�-placed-on-reverse side). _ FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED REVBY DATE -- -- ------- -- IEWED BY ------------------------- -------:------ - ----- DATE----- - BUILDiNG PERMIT ISSUED---------------------- _ - ----- --------- - ------------ ----- DATE Alterations and/or recommendafions:...._. <�` - _-- ----------- ------------ L ----------- - ------------_-- ----- --------JA .lT-04r__.----------�J-e ------------ ----- ----- ------------o�-- ---- -----e, ----- - - - -- -- - - D--`- t � .,r----------- _ ._..r.r .� - -- ---- ----- - --------- - -•------- ---- ---------- ------------------ ----------------------- i FINAL fNSPEC Date----------------- - SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazolton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9Th Street Stockton,California Lodi. California .- Manteca,California Tracy,California E.H.92M 1.67 Vanguard Press A