9965 - Laserfiche WebLink

Home Browse Search

` APPLICATION FOR SANITATION PERMIT Permit No _ k�omu�f� �� Duplicate]^ `--`' --` Do+e Issued hoe6v made to +6e Son Joaquin Local Health District for m permit to construct and indn||the wor work herein described. Thi" application ismade incompliance with Counfy (]n6|noncn No. 549. � iv -- A_-'--- AND � I - '.- ..~-~~~_.~.'~,+_---_-------------------------------------------------------------- Owner's ma -- . -'''''''— - --------''-�--'-''' Phone'''---''-------. A66ra,s----------------------------- Contractor's _--_..__-.Cpn+rac+nr, Name----------- ------- Phone----------------------------------- Installation will serve: ResidenceD4,Apartment House 0 Commercial rTrailer Court E] Motel O � El ' Nuo*ba, of living units:/------Number ofbedrooms Number of baths -/ Lot size --------------------- Water -----Water Supply: Public systemACommunity system 0 Private [] Depth to VVuterTabl Character of soil to a depth of feet: Sand E] Gn,vx| [-] Sandy Loam E] Clay Loam [] {]oy E] A6o6qV Hardpan [] Previous Application K4m6e: Yeo []� No [] New Construction: Yes [l No�kl FHA/VA' Yes [] N TYPE [}F INSTALLATION AND SPECIFICATIONS: � (No septic tank orceyspno| permitted if public sewer is mvm||u6|ewit6in 200 feet.) Septi Distance from nearest well-----------------Distance from foundation--------MuterioL----------------- Nu ofcompartments--------------------------Size------------------------------.-Liquid d -------Capacity----------------------- D : ` D 6o eS : Distance to nearest fn nearest lot Numburcf��u ''/�---------�-Un�g i � ---------Depth y�—.�-�_[--_-- oCesspoo|: Distance from nean:� w=U--- -D � n� � ��n-----_��ning mutu6oL---��_---- 0 Size: Diameter _-'''-'''�------------Dept h-''''''�'''--_��__��_Liquid Capacity----------------------------gals. Privy: Distance from nouro, well--------------------------- ---------------------Distance from nearest building------------------------------------------ F1 Distance fo nearest lot |��''—''''''-�'�'''----__.'-'__.'-----_-''''__.''-'''-''-''�'�- � \~ ' Remo6eling on6' ~ repairing (depch6:|:----_--'-_--__---..___.-_-__--._-._-----_-_----___- ^ ______________'______'_______'____'______________�________�__'___'__________ � __________'_____�____________'__________'______________''______'_`'______________'___- --__---------'_--------__-------_---------'------'_------'__�------__--_----------_��- -------------_-----------'----------------------------------- / 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. (Signed)-..-..--"----..]- ------------------------ ------------------------------'-----(Ownmn and/or Contractor) � ___-..__._--_------_---__.--_--------_-(Title)----_-._-----_---.—__ (Plotolan' showingsize of lot, location of sys+,em in relation to wells, buildings, etc.. can be placed on reverse side). FOR DEPARTMENT USE ONLY .`�,.�,,�" ". � "".`- . BUILDING PERMIT ISSUED_-------------- �� ,�' DATE-------- Alterations - ' ___ ��.��-�..�~4��_��.. -.l~1�t�y�^ —'-_'-�_'-_-_--''---�_-''---''�_-'''---''''-''�------_------_.___--_----_--___-__.'-_' —`---'`----'-`----```-``---``-`----``^---`--`------`---```-``-`-----`--``--'```--`-```-`---`--` _-_--._^_-_-_-----..__-------._-._--_--'_---_---_-_-_-_-__--_-._---._--_—_. �/� /' J� ' �-� RN/\L INSPECTION BY��'( �n+p -� =''-�i��'---'''-''------' � S�NJ�AQU|NU5CALHEALTHD|STRICT / ^ /om South American Street 300 West Oak Street mx Sycamore Street v/+ North 'xr' Street Stockton. California Lodi, California w*nlfilca. C^|nom|* nno', California ES-9-2M . n"°/=v 1'5z p,rzo.