22556 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: --------------------------------- ------------ -- A_ - ___._.___. APPLICATION FOR SANITATION PERMIT Permit No. �.c�•S. � w - 1 0- ---. -- (Complete-in Duplicate) V Date issued - ---------------------- This Perm it•Expires 1 Year From Date Issued ASplication 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 Or'dinance No. 549. 8 m ! JOB ADDRESS AND LOCATION-4----- �,, ( � � - _ f - Owners Name__4 Jli_#4_e_4__$ = .----------- [- t Phonee1 Addresso 0_ ........U.. ---------------------)-a--------------------------------- ----------------------------------------------- -------------------------------------------- Contractor's Name' Q - -- - ------- -- - -- - ----- --- - -- - --------- --- - -------- -- Phone---------------------______------- _ - € Installation will serve:]t Residence 50 Apartment House ❑ Commercial E] Trailer Court ❑ Motel ❑ Other Number of living' units:`_.__ Number of bedrooms _ R f Number of baths _ Lot size __ _k_I_-- _-__..---_ Water Supply: Public system g Community system ❑ Private]❑ Depth to Water*Table --- . ft Character of soil to I depth of 3 feet- Sand ❑ Gravel ❑ Sandy Loam 0 Clay Loam; Clay ❑ Adobe❑ Hardpan ❑ Previous Application Made: (If yes,date------------------- ) No New Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank`` a�_,Distance from nearest well---._. .---------Distance from foundation_.--------- _Material _- _______ --------------------- 14 % .__-_-. . _. _ No. of compartments _S'ize__ ____ �* Li uid de th:._ - Capacity = '�- P , q P. - --. p y...-- --- is Sa FieL"d � Distance from nearest well_ _Distance from foundation 1-__ --.Distance to nearest lot line ___._..... ( - �] �" Number of lines --------- .-- .-. _Length of each line _ .,C f t.---- !...Width of trench � -------------------- T _______ _______ "V Type of filter material `_ ---__Depth of filter material_ . f` _ _--Total length-------- -----------------._. -- Seepage Pit: Distance to nearest well440_-� -Distance from foundation_*I. -_.Distance to nearest lot lme----------------- Number of pits--- -----/_.: .. Lining material------ -------- - Si Diameter'.�_- --_----__Depth----------- 1-1--_. . CesspooP: Distance from nearest well ______ _______Distance from foundation ------------3-.Lining material----------------- --.---------------- 0 _-_. _____ Size: Diameter. .. __ ._- __-----.._..Depth----------_------------- .).'. .._ --- __ - I.-Liquid Capacity ____.gals. Privy: Distance rom nearest well + Distance from nearest building_ _________ ____ _____ Distance to nearest lot 'line I ❑ - --- ---- ------------ - '� .. -------- ---------------------------------- Remodelin and/or repairing (descnbeJ:_-- �(i�- : . (�b r .R. --- 6 -- ------------------------------------------------------ - - --------- --- -- --- --------------- - hereby-Lcertify that I have prepared this application and that the work iWl`be done in accordance with San.Joaquin County I ordinances, Sf ate lar, nd rule and regulations of the Joaquin Local'Haltth District.) v a(Signed) - ` Owner and/or Contractor) By:--------------------•...... - --_- -- - -- - - ---- ---------(Title) ---- --. ...--- ---- --------- (Plot plan, showing size of lot,location of;system in relatio to wells,buildings;etc., can be placed on reverse side). FOR,DEPARTMENT-,US.E&ONLY ` _ .APPLICATION AC EPT BDTE REVIEWED BY_tc DATE_----- BUILDING " PERMIT ISSUED__.__ . _.._ .__._ DATE. _..-. . .__ _ Alterations and/or recommendations:_p'----- -------- ------------=--------------- 1. - - - - -------•--- ------- ----------------- --------- ------ ---- ------------ --------- ------------ ' -----------------.------------------------------ -------•-- ---------------------------------------------------------------------------------------------- . ------•---•------------ - ---------------•-------------1------------- ------- -------- ---------- - _- - - --- ------ - --------------- -- -------- ----_------- ......... ----- --- ........ „---------------- FINAL - -----FINAL INSPECTION B '� - --__-. --._-. =- Date_.. ) r r ^, r SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Lodi:California Manteca,California Stockton,California Tracy,California E.H.9 2M`1'=67-n Vanguard Press :