21829 - Laserfiche WebLink

Home Browse Search

�T FOR OFFICE USE: T -------------- ES 1Y- ------ u _______________________ p• ------ .--. --"--------- -------------- --- ------------- APPLICATION FOR SANITATION PERMIT Permit No. a- ------------ --- (Complete-in Duplicate) I This Permit Ex fres 1 Year From Date Issued Date Issued Application is herby mad9 to the San Joaquin Local Health District for a permit to construct and install the work herein described. This apl,li�a+.i��, �,�-a�9 in compliant wifih County;O.rdinance No, 549. 22 f -� rZ.�tro_S' JOB ADDRESS AND LOCATIO ._.:�_�•:4__7_!_(ti��CU l-r"_1D.. .' +`��._.Ot=----M --- `2� j� j� Owner's Name ----J•-f..-`-"•__u. •--- U-© _C i-_ S------------ . �^�, • --------------- '-- -- - - Phone--------------------• - •- Address 1. .L __'150------ L�1�: UL- ------RD- ........... Contractor's Name____ ____ _ JLL `apppp �70o K;i l46`W. i9vm- - -- ---- `phone----- Installation will serve: Residence 21--. partment House ❑ Commercial ❑ Trailer Court ❑ Motel p Other ❑ Number of living units: " _._._ Number of bedrooms 3. Number of baths _ Lot size -----�� -.- 0 Water Supply: Public system E] Community system E] Private 2r Depth to Water Table . ft `a Character of soil to a depth of 3 feet- Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam �NoO ❑ Adobe ❑ Hardpan Previous Application Made: (If yes,date............ .. l No 2---'New Construction: Yes w _ _ FHA/VA: Yes E o tl —TYPE—OF—'INSTAL•LATIO'NANDTSPECIFICATIbiI-.(No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic T k: Distance from nearest well____0-----Distance from foundation____/Q--------.Mater*al (200 �No. of compartments-. --- ^--------Sizeyiyj0—'__X "--G---Liquid depth__, Capacity--_--1 Disposal F id: Distance from nearest well-... ___-Distance from foundation._/Q"----•__..Distance to neares to line_-__�____-Number of lines _ -___-__-________Length of each Gne__ a.f" j C� "-.Width of trench... F� ___r�Type of filter materia#--S-0_C.�___pepth of filter material__._. - gTotal !en th___.._..._ ---Seepage P't- Distance to nearest well____10,0---____Distance from foundationfQ--.---.Di once to nearest lot line___-Number of its--;.P ; -- --'--Lining material__©.C _-- Size: Diameter-- -----------------Depth_-_ - f - :___-- _-- Cesspool: Distance from nearesf well ________________Distance from foundation ..............-_ ..Lining material-. - -- ..-_.__---------------------------- .-...___.______-__ - - --- I- --- • Size: Diameter. .. ---- - ---- "---- -Depth------ --- -�----------- ------ ---- '---- Liquid CapacifY-- - ----------- '- ' "gals. Privy: Distance from nearest well._--------------------------------------------- .Distance from nearesf #wilding___.__ - . - . El Distance to nearest lot line ---------_.._._._. - ------------ ------------------------------------------------------------------------------------------------------------ Remodeling and/or repairing [describeJ----- -- -------- ---------- --------------•------------- ---------------------- -•--•--------'-- ----------- ------------ ----------- f PERM 3"r Q�TR1_ vE-D- 13s1T ----- H .__Coclt� �cVOT-__D� 0 IzA -------<P_Af A _T_E; )----------robe. Pry RV_Icc t3an rt� �o `r-� Dd..- r ---�1D t2K- 7-1A,0--------------------------- 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 Disfric#. 5i ned � (Ow J - .. - .��r:-•9w'-+�r^$^�,;,a:�,�w,.awtr._,�„�" ,__ --- --� --- -- - (Owner _Contractor)' •^�r�� ner By:-------------------•-----------------------...-r - ----------(Title)------ --- -------- ----=----- --------- - ---------- ; [Piot plan, showing size of !o}, location.of sys+em in relation to ells, buildings, etc., can be placed on reverse side). t p FOR DEPA TMENT USE ONLY APPLICATION ACCEPTED BY.__- i.>`�.<C]------------------------------------------------------------------- ------ DATE_-----J- - 7 �� - - R1VIEWED BY - - -------------1--- .-------- --------------- ----------------------- DATE BUILDING PERMIT ISSUED-------- -- ------------ ----- ------------- Alterations and/or recommendations:."_--.. .As.,�___--fWEF�R----rd-_._-`rQDc� ._ S r� - Rvl -. -_ FO-S _.._.d_[vF0........ .N� ..... _HRA{�-----OFF---- ..- '_.,. dITiiy �°cfiDuR�l� L --------------------- - ----- - ---------------------- --' 4 FINAL I - `� Date----- SAN JOAQUIN LOCAL HEALTH DISTRICT r' 1601 E.Hozelton Ave. 300 West Oak Street 124 Sycamore Street • 205 West 9th Street Stockton,California Ladi, California Manteca,California Tracy,California E.H.9 2M 1.67 Vanguard?cess