844 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SAWATION PERMIT (Complete in Duplicate) 44 Application is hereby made to the San Joaquin Local Health District for a permit to construct and This application is made in compliance with County Ordinance No. 549. , install the work herein described. JOB ADDRESS AND LOCATION-Jo------JPg"-MjT.A --------------------- Owner's Name-----•-----•-------------------------------129---��.--- �'.;..�....y� -----------------•-----------•---------------------------------------.. hasta__.S-tr_eR Address-------------- } --- Phone---2___�Q Contractor's Name ------------------------------D•-- .___Far_r_ish Sans- ; ----------- Installation will serve: Residence +-----I-ne a" ------------------------- Phone___---gam"�6Q7 Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel Number of living units: bedrooms Number of ❑ Other E][!- Number of baths 0 Lot size__AVa11ahjje 2._tx3_ pt minus Water Supply: Public system]M Community system ❑ Private ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe EX Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well_________________Distance from foundation______ ❑ No. of compartments------------------------ ------.Maferial------------------------------------------------- Capacity-- Size -----------------Liquid depth--------------------- esspo❑ Size: Qiameter- ol: Distance from nearest well____:__.__.___-_Distance from foundation___________________ Lining material------------------------------------- --------------------------------Depth------------------------- rivy: Distance from nearest well__________________________ Distance from nearest building-_______________""-____ ❑ Distance to nearest lot line - ------------ - ------------------------ Seepage Pit: Distance to nearest well-------NOZIe----Distance from foundation_____ 101 ------. istance to nearest lot line-------5t xx Number of Pits------SI._________-_Linin material.__ «4�1 a--- g ----•-- --------��: Diameter-------- ------------Depth-----2 � Disposal Field: Distance from nearest well------------------Distance from foundation--------------------Distance to nearest lot line, ❑ Number of lines-----------------------------------Length of each line------- Width of trench----------------- "" Type of filter material-------------------------Depth of filter material Remodeling and/or repairing (describe):------------S_uP-PJLeM-er1-t___t0--�3sainage----system---.-4-------------------- -: ----------- l ------------------------ ---------------------------------------- ---------------------------------------- =----------------------------------------------------------------------------------------------------------------------- hereby certify that I have prepared this application and that the work will be done in'accordance with San Joaquin County ordinances, S ws, and rules and regulations of t San Joaquin Local Health District. (Signed)------D --al! I . ' «.: -----------(� By: �.,,- r Contract - (Title)------Estimator (Plot plans, s owi size of lot, location of system in r tion'to wells, buildings, etc., must be' filed with this application). ar FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ______"" -"_ REVIEWED By ------------------------------------------------------ DATE----------- -- ------- - - ------------- -------- - --------- DATE---------------•----- --- � --- ------- ------- BUILDING PERMIT ISSUED-------------- -- ---------------------------------- Alterations and/or recomm ndations_______________________" DATE -- ------------------------------- ---- --------- _ - �.eL..f --------------- - - -- ------------------- --- ----------------- ---- ------- --- --- - -------- 'r ------------------- ------------ --- - ------------- --------------------------- ----------------- ---- ---------- ------------------------------ PERMIT No.-Z 'j ISSUED_____"---:-1 +� -------- --- _(Date) FINAL INSPECTION BY:___.__"" (! ------------------------------------------ Date--------or �! SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street ES-9•-2M 9-50 W4639 Stockton, California