16129 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: "'P '` Permit No. .P-��•-Z=•• � -------------------%-----------------"-------- " APPLICATION FOR SANITATION PERMIT -----' (Complete in Duplicate) Date Issued ,--- ................... This Permit Exp fres 1 Year From Date Issued hereby made to the San Joaquin Local Health District for a permit to construct a instaVl the work i described. i &i,- App Is Y fiance with County Ordinance No. 54 //Z aA This application is made in comp f� `� f�� ,; .. JOB ADDRESS AND LOCATION---- --------/�.---- --- =- W - • -- Phone. vzf-x7 7.6--_--• � . . _ "rt ,Id_ - ------- r Owner's Name: ---------------•---- ---------------------------------- -Q_ -------- �. , Address.-----_----------------- ---•-•-- •• i Phone..--- -----------•-------------------------•----------------•--._....- ;. - - Other Contractor's Name--------------------------- ------•-•- --•--= ----•-- ---- Motel ❑ ertment�House ❑ Commercial ❑ Trailer Court ❑ �� ! f� Installation will serve: Residence Ap Y •-------------•-- 1_-_ Number of bedrooms _-, .- Number of baths ��Z•- Lot size ----------------------- ----------- Number of Viving units: .- ¢ Depth to Water Table �.-- ft. 1 Community system ❑ Private DeP Hardpan ❑ E. Water Supply: Public system ❑ R ❑ Clay Adobe❑ Gravel Sandy Laam� Clay Loam Y ❑FHA/V � No ❑ Character,of soil to a depth of 3 feet: Sand ❑ ❑ }w Construction: Ye , No ❑ A: Yes Previous Application Made: (if yes,date- s�' "1 NO ❑ N� l j TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet. t p I? O ,.35G ---•---Li Liquid depth- Capacity ��•• Septic Tank: Distance from nearest well-- ._. D1Zeance frotfoundationq_._-..- -•--.Ma}eri - r� No. of compartments-.------�' Dis o al Field: Distance from nearest well ` �--flistance from founds!is;5. ?'-.Width dth ofttrenchest lot line ----.--.-'-: p Length of each Vines 1 v Number of Vines--------ox. ---De th of filter material........../-�---------Total length----------------� --•• � x Type of filter material,. . P Seepage Pit: Distance to nearest well----------------------Dist a frim-- oU IdszenDiameter----------------------- Distance t--Depth St lot line-------------- - Number of pits----------------------Lining ma k ❑ e Lining _. ` Distance from-nearest wail-------------- •-Distance from foundation--------------------Liquid Capacity--------------• -------gals. Cesspool. f -----------------------Liquid Size: Diameter--_`-------------------------- mance from nearest building-- {�--- 1 �� Distance from nearest wel -_---- ---- `� r------------ � l Privy: ------ 1 ff Distance to nearest lot line z --- - -- �: Remodeling and/or repairing (describe):____-- --.. __ f �` At� _.. ---- ;�;t --,1, this a licat nand fiat th Mations of the San Joaquin I hereby certify that I have preparedPP a work will be done in accor_da tg? ith San Joa um County ordinances, State law and rules dreg Local Health District. ----------------(Owner and/or Contractor) \ 4 (Signed)--t- --- ��--•-- -------- ----------- ------..-------- (rt s (Piot plan. showing size of lot, location of system in relation to wells, buildings, etc., can be pace on reverse si e. FOR DEPARTMENT USE ONLY DATE----------- t APPLICATION ACCEPTED BY.---- -- --------------------•--------•--------------•---------- �� -7--- _-------------- ----- .- DATE REVIEWED BY-.------• '- ------•--•-------- DATE------•------------ ----- - --------- --- - BUILDING PERMIT ISSUED-------- -------- �o�.� t �54e, ��'= --•-- I Alter ions rid/or race mend tions:---__Ll .--f ---- - .t______________•- ".�. -- . ------ `--- ---------------- aL ------- FINAL INSPECTKDN BY:----- 16 SAN JOAQUVN LOCAL HEALTH DISTRICT 6- + (.� 124 sycamore Stmt 205 west 9th Street sbj uth American Street 30G West Oak Street Tracy,California "1i� Lodir california Mantas,California Stockton,Caiifornla r ES 9 REVISED S.59 2M 5-62 ATLAS - r