16581 - Laserfiche WebLink

Home Browse Search

l� rvR vrriLt USk: (v r r 6 a - "- ,-d // p r -------"----- ---------------- -y---- APPLICATION-FOR SANITATION PERMIT Permit No. ..(.�O.�D + (Complete in Duplicate) " This Permit Ex fres 1 Year From Date Issued ------------------------------- - 1 Date Issued .__r�___� Application is hereby made to`.the San Joaquin Local Health District for a permit to construct and install the work herein described. This appliCati�n i�ma in-c pliant' w' ounty Ordina No. 549: 15- 3 ' , JOB ADDRESS AN `� CATION_... . '_ 1 CL.. ... C'4�- •[� -- - ------- - Owners Name` 3_ r' �5.' i ---------------------- --- �h r .- ----------------------- Phone------------------------------------ ..... •-- h t. Contractor's Name.....:...... .. . . - # Phone. Installation will serve: i.Residence partment House ❑ Commercial _ ❑ . Trailer Court E] Motel ❑ Other Number of living units: _ ----- Number,of.bedrooms _ f .Number of baths' size- Water ❑ Supply: Publics stem Lot _-X_k(-k_./---- pA Y� t. - ----- Y ❑ : Community system ❑ Private ��epfh to Water Table 6__ ft. Character of soil to a depth of 3 feet: i ; P Sand ❑ Gravel ❑ Sand oam ❑ Gay Loam ❑ Clay Previous Application Made. '[If.yds,date--------------- j No New Construction: Yes o ❑ Adobe hardpan ❑ �r ®�P`�❑ FHA/VA: Yes ❑ No kg-- TYPE OF INSTALLATION AND SPECIFICATIONS:..., ¢ I (No septic tank or cesspool permitted-if public sewer is available wifhin 200 feet.) Septic T ,>_k p Distance from nearest well."__- f, : —.._Distance from foundation--- -- ---------Material OhWe-` No. of compartments- __ �-------_---Size.__6..x-/_C-----Liquid depth._" Capacity._ v _--_-- -. ---- 1, Dis osal eld: Distance from nearest well---�V-_j_.Distance from foundation./0___�--_-.Distance to nearest lot line_S._..J.....� p Number of --------------:Length of each line.. . ."__'� �� --_ ` Width of trench _y'� Type of filter material''" � ' "ZkDe t -- - ,��:---- ------ p h of filter material. � -' ---""---- i ,l Total len th.__ Seep it: Distance to nearest we'1l_/ ----- from fou dation_._�6_� Distance to nearest lot line�___�-_-. Number of pits.. " _--_ - - Lining material... -C ' :.SizE: Diameter. sS' %------Depf6.2-j-�__/ �L Cesspool: ¢ Distance from nearest wel!-----------------Distance from. -______--"_---" e Linin material 5�ze9,Diamete_ �---------------------=-Depth._`' ------------- a ---- 9 _--- -------------- -------Liquid CapacitY------- - gals. PrivDistancek . ❑y: from nearest{well.-,--.._-_--_---- .___- __�__._--___ Distance from nearest buifdin Distance to'nearest%lot,line- ------ g ---------- • ; . . � J ---------------------------------------------------------- Remodeling and/or repalring (describeJ:...�_' .l r � " 44 ------------------- ---- ---------------------- ------------------------------------------ ------ -----------------------------------'-----------------------------.-----------------------------------------------•..-----------..--....._- •--...._..._---------_ ----- ------- c:.� ✓ ..." .... ..-.._ ------------------------------- - .c ............. _.._•,_�t-�. ..__ -.._-_....__...-_....- __ -....._---'—.-..------------"...------...--..----...-.------------------------.._._.."- I hereby certify that I have pre ared this applicafion and that the work will 6e done in accordance with San Joaquin County � ordinances, State I - S. nd rule n lations of the San Joaquin Local Health District. �' (Signed)------------- - l ------- -- --- --------------- --------------- ------- --------------------------------------- (Owns_r and/or Contractor BY=--------- ---------------------- ------(Title).e (Plot plan, showing size ot, location of.system in re a ion to wells, buildings, etc., can be placed on reverse si --. # FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY---- REVIEWED BY ---------------------- ------------------------------------------ DATE /1:__5 s -3 - =----•--- DATE----- --------------------- ' BUILDING PERMIT ISSUED------•--------••---- -------------------------------------•--- - ------------------- ----------------•----:------ Alterations and/or recommendations: � -'R t(U-' �-' Is^t-. . DATE --�-------------------------- a h S Ell.-: � -------------- i ----------------- ----- FINAL INSPECTION BY:----- ------------------ Date...__lz._' ----------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hasellan Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California �+ ES 9 REVISED 8-59 3M 3-'63 F.P.CO. Tracy,California r- t