Laserfiche WebLink
_s <br /> ----------------------------- -------------------- Permit No. <br /> APPLICATION FOR SANITATION PERMIT <br /> --------------------------------------- (Complete in Duplicate) Date Issued <br /> d ----------------------- This Permit Expires I Year From Date Issued <br /> --------------- .4 <br /> I al Health Dist V, At-461&struct and 'install the-work herein described. <br /> jApplication is hereby made to the San Joaquin Loc District for.! permiT-Td­6(1b.__ -- -_ <br /> ;This application is made-incomplia c#-4itK-CbjffW(YrdiRin--ce-No�549. 9 xS0 - e� <br /> 411 e. <br /> • <br /> �0( 1*>-------------------------------- <br /> ;JOB ADDRESS AND11''LOCATION `----- _5T-------- <br /> ------- Phone ............................. <br /> Owner's Name----- -`--..•------------------------------------------ <br /> f - -IF:k 4� r, &VINTELCA <br /> ba UEL I �,vr__Sq R 14 WM 0 j Lj ............---------------------- ---•-•--•------•--•-•-----.. <br /> . ....... ------------------•_­Vw---------- <br /> ------------ ---------- <br /> Address-------------------------------------RL ­- ------- <br /> I - n� M Phonel.. <br /> �[CON,,actor's <br /> T-OFHC.E <br /> ----------------------- <br /> Mntel a D <br /> rtvp <br /> Trail <br /> House [3 Commercial [j <br /> Installation will ser.vej. -'.Reiicle��681011 apartment <br /> F7 <br /> Pit -4 bar of bedrooms t-=. Number of batKs -7---- Lot size .... <br /> Number of living uni Co <br /> urn <br /> *! th to Water Tabla�7y: Publ yst 0rTimunity sy rn. F] Private F1 Dep 7__—f—t . 3b, <br /> e�.rrll <br /> Water Supply: i'� Tfe f: 'Sand ;;��Gravel [j Sandy Loam Ej Clay Loam [] Clay❑ Adobe 0 Hardpan 0 <br /> -ter of soil to I'd' ptr-of, <br /> Charac <br /> a I <br /> 4 <br /> Previous Application Made: if 7,'ps,date-------- -------.---) No 9New Construct <br /> �-TYPE�-OF-41SISTALLkTION A41) <br /> ion: Yes Zj'No [I FHA/UA. Yes E) No <br /> J1SPEC-IFICATIONS:--_` <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Dis6n'c_e_'from 4neares well from foundation'0 P` <br /> -L"--id-depth__-_ ------------dalbacity---T........... <br /> r ---------- 7 -.K - lqui <br /> 'Size-3X-9. -S-7 <br /> Septic' <br /> No. cif-comW <br /> _7 7 'est lot line................. <br /> -Distance to new <br /> i. <br /> Disposal Field: Distance from nearest well'!..--.--.Distance <br /> Number of line, ..--Length of each line------120- ----•Width of trench...._..7 ------------- <br /> Type of filter rn----------- ---ROCK Depth of filter materialength......._._...-Z ---------------- <br /> I . Nt) <br /> atlrial5w_------------ --- -_-......Total ---------------- <br /> ......:!�D`I'stbnce to nearest lot line................. <br /> rest well------7!L!.��_±_M_Distance�fro-nn-jouncla <br /> Seepage Pit: Distance to nearest 't <br /> sk,- it.fkt! 1 -------�Dep;.h----------------------------- <br /> -----------Size: Diameter--------------- <br /> NuTfiber of pits-- ----------------Lining material <br /> rl%r- <br /> Cesspool: Distance from -nearest well-----------------Distance f oun ation------------------- Lining material_ ----- -------------__----------- <br /> 'Size: Diameter------I--------- --------------------Depth --------------------------------------------Liquid Capacil---------------------------gals. <br /> ❑ <br /> PrivI rest well-----------------------------------------X.,VV Distance from nearest building........_-_----..._..--.------.---------. <br /> y: Distance from.nea ----------------------------------- <br /> 0 Distance to nearest lot line---------------------------------------------- ------- ------------------------------------------ <br /> L <br /> I ------ ------------------ ------- <br /> red/or repairin descriter <br /> Remodelingble):--------- ---------------------------------------- --------------- -------- <br /> 13.... <br /> . .... . -------- ;V <br /> -----------------------------------------------------1............ ------------------ <br /> 157----F_MLE47�a;sl-----------------­----------------------------- <br /> - --------------------- _ <br /> 1 ---------------------------------------------------------- ---------------------------------- <br /> -----------------­------------ -------------------- ------ ---_---------- ---------------------------- ---V <br /> ce with an Joaquin County <br /> 'S <br /> I hereby certify that I have pr�epaAred this application and that the work will be done in accordance with <br /> ordinances. State laws, and ru end!"regulafions of the San Joaquin LZA Health District. <br /> ------------------ wne and/or Contractor) <br /> (Signed)x. .......... _-- ----- ----------- ------------- --------------------------------------------------------------- <br /> ....................... <br /> A ----------------------------------------_--------------------(Title)------------- <br /> -- -------- ---------- -------------- <br /> reverselside). <br /> (Plot plan, showing size of lot, location system in relation to wells, buildings, etc., can be placed on <br /> ME SE--PN <br /> EPAR . qT_U 41 <br /> _T_ <br /> ------------------ DATE..... ------- <br /> APPLICATION ACCEPTED BY--------- --------------- <br /> klREVIEWED BY-----)--------------------------------------- ------------------------------------------------------�-------------------------- DATE- <br /> BUILDING <br /> PERMIT ISSUED----------------------------------------------------------------------------_---- ---_------ DATE-. ------ <br /> Alterations and/or,recommenclatic�ns------------ ---•-------------------------- ------- ............ .........-------------- <br /> ................................-------------------------------------------------------------......L............ <br /> ------------------ --------------------------------I------------ --------------------------------------------------- ---------------------------------- ... <br /> .......... ----------------------- -------------------------------------------------- ------------------ ----- ----------------------------- -------- <br /> N --------------------------------------------------I---------------- <br /> ----------- <br /> ----------- *-- ------ ----- --- -------- ------------- <br /> - .................------------- <br /> ---------------------- --------------------------------- ---------------------------------- -------------- <br /> -- ----- ----- <br /> . .......... <br /> Data_--.- ......... ------------- -------- <br /> FINAL iNSP N ...... - --------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street Soo West Oak Street 124 Sycamore Street 205 west 9th Street <br /> r Lodi,California Manteca,California Tracy,California <br /> Stockton,California <br /> Ell 9 REVISED 8-89 RM 5-61 ATLAS --L <br />