1088 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. ZO-JOz�-- \ (Complete in Duplicate) Dofm |oue6. ---- Application is hereby made to the Son Jo-aquin Local Health District for * permit to cqnsfruof and install the work herein described. This application is mad I' ce with County Ordinance No. 549. e / _-_- � - __ 11 V---- --- -- ----- JOB ADDRESS AND LMIf --- �mmonc|o| � Trailer||er Cou� � Motel � Other El Installation will ~~\ ^o,ve, Residence 'orhnont House 0 Nvm6erofliving units- -/. Number ofbedrooms 3- Number ofbuth,l.&�L o+ ,ize ------------------------- Water -----'_--W*ter Supply: Public system El Community system E] P6vo+a Eq~Teo+6 to Water Table . ' ft Character ofsoil to a -den� � 3 �� Sand � Gm�� 3nn6v Loam El �nyL�m [] Clay F] /�o� ��Hu��n [l k ' � »�& PreviousK4o6w: &m [� No [� NewCon�nc�pn� �u, [� Nu [� TYPE (�F |N�T�LL�T|(�N AND �P��\FK�/q1ON�� l . � .. - - �� °°.�� h 200 feet.) ' UN* septic tank cesspool ntou ifuo//csuwerma ". Septic Tank: Distance from nearest weil-J-10A------Mstance from foundali ILA----- ------- artments v ' at'o D---� el6` Distance from nearest weU.10-� - found Number of lines _-*. ^ Length of eock line �JI ��... �Vid|+h of trench --_--_ Typeof �+vr matehoL _-'Drot f |iu, mu��r° 1 _ �no+6'''1'k��_.'__.__-. Seepoge R+� Distance to nearest weU----.__D|��nco from �oun�o�un.---_-__-Distanceto nearest lot line--.___ ~ F-I Number of pits-----------------------Linin 9 mu+er�al-��'---'-Size: Diameter'__.'�-''-Depth--------------------------------- -, C� pon|� Distance from neor�nearestwell �_.-_Didnnco from foun�ut�on-------Lining mo+era|_------__---_ - Size: Diameter--------------------------------------Dept h----------------------------------------------------Liquid Copocify----------------------------gals. ^ Distance [n�m nearest �mi|��g------------------------------------------ Distance Privy: Distance from n�o"�two|L----_----._'-_�� nnn . ''-'-'_-_---'_-'_ - ' Distanco +onnnnast |otUm*--_-__-.__--_-_---_'-____._'_.--_'-_--__''-_'-_-- � Remodeling and/or repairing (600x�6a\------- , -_-___-__----___'--_--_-'--'--__.--__�_.----_.___-_-_-___.----______---___-----__.'--. � _-__-.___'__..______._____-___-___-__-___-_----____-.._-.-_.'__._---_-__-'-_- _-' ----`--''--------''-----`--'-------'---'--'-----------'------'---```- -^ ------'---'I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, f laws, and rules and and/or Contractor) ' ,~,'~~r--~--^~-'--''--'---��w' ~-�ari - jS,,-a ' 0v� --_---''-----____----..__----'--'----'---'r`~,--'---'-------'--'�� (� plan,' ��showing size of lot, location of system in relation to wells' buildings, etc., can be placed on reverse side). FOR )EPARTMENT USE ONLY � " '�_�'-��--_-'-''----.--__---__-_--.T-_-'--�'.-.-_-----'_-_---'-�-�-��--��-�-�---_ DATE --_-PPL|CA|xJw ACCEPTED BY ~�,'�, � `' ------------------------ DATE ----------------------------------------------------- BUILDING PEKK |\ ISSUED Alterations and/or nocomnendaHons;��''----'_-- ------------- -------------------__-------_---_--.-------_--.---_--_-__----._-_---'-_-_-_-._ ----------------------------------- ----------- ------------ .__.__.____-_ --_'_ _'-'_--__--_--_-__.'--__---._-'-----_-_-._----'-_-_---_-.---_--.._____-_._- ----_-''---''--_----''-'-_-'''�__---�--_.'''''�-''-'''''''--''-_' -''-'--''''''-__''''-_.'_-'----_- ' ---'-''---'''''---''''''--''-'---''''--'----'-- ^� � FINAL INSPECTION // D�te '-'�~�� -��-'-------------------------------------- ° --_^ � 5�kNJ[}��U|NLOCALMEALTMD|�R�T ^ --��^~ ' m� North "C" Street ^ 130 South Amer�" �� ' �� k S� |� �� S� � ' sv""kto". C°|/;","ia Lodi, California Manteca, California Tracy, California ES-9-2M �5/ n°.�"u W-2100�