15836 - Laserfiche WebLink

Home Browse Search

FOR OFFIC�U S '. �` - w� -= 4 _{ - = - 1- ---�li --- �' Permit No. . _.5.1�-_ _--•- i _ �ic�{�,3 G? r APPLICATIC�i``FfR SANITATION PERMIT J c/" ----__----Pp ;t- - ----- �� (Complete in Duplicate) Date Issued -__.�%__ _ r/-•------_..- 0771. This Permit Expires 1 Year From Date Issued ' Applicatio i Aga = e d o. I Health District for a permit to construct and install the work herein described. This application i made in compliant'e t��rdinance No. 549. �� q -----------•--------•-.----------••-------- J DDRESS AND LOCATION----- .� - ------��:--= -t,--�-�-�---------------------• -•- Owner's Name------------� -d'S= '�----••--=• ......... �1G.�l.- _.�,d.-�-�--.. Phona. C� t� l Address . -------•---- . ------•---------------- ------ - Phone Contractor's Name-------------------- ----_--------------_ ------------•--------------•---------------- --------•--•-------------•-•--- Installation will serve: Residence V Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other El r ' i -275 Number of living units: J--- Number of bedrooms --- Number of baths — Lot size ._. -----+ �� Water Supply: Public system ® :Community system El Private ❑ Depth to Water Table __..-___ ft. �� Character of soil to a depth of 3 feet: Sand ❑ Gravel El Sandy Loam [I Clay Loam ElClay ❑ Adobe�Hardpen C1 Previous Application Made: (If yes,date____________________) No ® New Construction: Yes 19 No ❑ FHA/VA: Yes❑ No ❑ TYPE: OF INSTALLATION AND SPECIFICATIONS: , (No septic tank or cesspool permi_tted if pub'c sewer is available within 200 feet.) f� Mateal_�.rexlG Septic Tank: Distance from nearest well./0"��Distance from foundation -- No, of compartments----------;.2'—J-------- Size__ .X X .Liquid depth -7.12;__" ___________Capacity__ 'Disposal Field: Distance from nearest welLzl-eDistance from foundation.._ .........Distance to nearest lot line.....+ __... ` Number of lines-----------------------------------Length of each line--------------------•---------Width of trench......241-1-:---.------------.-- De th of filter aterial__ ?y."__._._.Total length____, _ ------------------- Type of filter material-_ �1 --- a p _ g__Distan_ rom -ou atDistance to nearest lot line.________..__ Seepage Pit: Distance to nearest wellz __ . R . -------Size: Diameter k�x=/t .Depth-- `A ... 1" Number of __ mater L,�. \ Cess ool: Distance from sneare�well_. 'nf� -R._Dis rom foundation____________________Linin I pq material.. ------------------ Cesspool: -------...- ❑ `Size: Diameter--------•-----------------------•- �_Depth_----------------------------------------------------Liquid Capacity----•--------------• gals. Privy: Distance from nearest well--------------- _______________________________Distance from nearest building------------------------------------------ [] Distance to nearest lot line--------------------- ...............-------=--. -------- _. Remodeling and/or repairing (describe):------ -------------- ----- - µ ---- -.-.R. - - - ---------------------- -------•-•-- -------- ----•----------•--•--- ----------•--------•---------------------------------•-•-------•----------------•--------------------------•-----------•-------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. 1 (Signe •----= -4- (Owner and/ ' '' :f , (Title)---------------------------- ------------------ --------------- _ -------- ----------- -------------- By---------- (Plot plan`, showing size of lot, location of system in relation,to wells, buildings, etc., can be placed on reverse side).,- FOR ide).-FOR DEPART NT USE ONLY APPLICATION ACCEPTED --------•---------------- DA - .------------- 1 ---- ------ ----- -- -- TE , 4 ----- .- DATE------ ----- REVIEWED BY------_--------------_-----t •--- ------------------- --- ------------------- ---------------- _.. _ .. BUILDINGPERMIT ISSUED----------------------------------------- ----------------------------------------------- Alterations ---•----- ---------------------- DATE - '�----------------------------- ---------- Alterations and/orrecommendation .._... __ f �:---� rte`-`'--- -^ - �•"• •�� F -- --------------- f/ .... --------------------------- -------_----- ------..------------------------------------------J. --------------- --------------- -------------- _. ------------------------------------ ---------------------- FINAL INSPECTION BY-_ --- Date ---------- --------- ------- --------------- -- --------- SAN OAQUI OCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California _ Manteca,California Tracy,California EB 9 REV16Ea 8-59 2M 5-61 ATLAS