SU0006111 - Laserfiche WebLink

Metadata

Thumbnails

Annotations

Permit No. __Z to - ��1-. JCATION FOR SANITATION PERK z.�a.. "� - (Complete in Duplicate) !J (� --- Date Issued .... This Permit-Expires 1 Year From Date Issued Application s hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance.with County Ordinance N 49. JOB ADDRESS AN LOCATI - --- - ----- .-------- Owner s Name.__- -- rn . r Address-...... .7--------- - - ----- ------- -------------- - ------ -------- ...............------•---------------•-- --•---------------------•-- Contractor's Name------------ --------- ..�t ------------------------------.-------------------------------- .......--.-.---------- Phon - 1 Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trail erourt ❑ Motel ❑ Other Number of living units: ........ Number of bedrooms ........ Number of baths p?____ size _______� ^��..__.__ -----`___._______ Water Supply: Public system ❑ Community system ❑ Private,g]--te.pth to Water Table _ ft. 'r Character of soil to.a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe 21`Hardpan ❑ Previous Application Made: Yes ❑ No P__f ew Construction: Yes o ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: Septic Tank: Distance from nearest.well�Q@_ t Distance from foundation----��--- e (No septic tank or cesspool permitted if public sewer is available within Y00 feet.) • p Material_--�- _�- ------=----------• No_ of compartments-------. ---------------Size__ _`S7}_- j --Liquid depth--- %Z--- --------Capacity.:: G ------ Disposal Field: Distance from nearest well/"---/..fi Distance from foundation..Z..&I-.t___Distance to nearest lb#.lihey__, ❑� Number of lines---•---.vZ--------------= Length--of-each dine___��t;!��--...,Width of trench-------�y_. ------ _-.- r� 'y { ------- Type of filter matenal___S_[_______________De th of filter material � Total len th;.._.......��.. �._________. YP - p� x----- g P Seepage ,rt: Distance to nearest weIIJO.4.:............Dista'rice,4ym�foundation_.-�D ` p ..___.Distance to nearest lot fine �_�._k.._ Number of pits-------d�....._-----Lining mater i ____Size: Diameter.__-I'll_ __._Depth v � .... Cesspool: Distance from nearest well.................Distance fro.T foundation____________________Lining malterial-------------------------1 -_____:_-____-. .____.Cf: s ,. ❑ Size: Diameter. .........Depth----------=---------------------------------- `-----Liquid Capacity--- •-----•- ---gals: Privy: Distance from nearest well________________________`1. __________;:_____:___Distance from ,nearest-building----- _=;q _..._.......- ---------- ❑ Distance to nearest lot line-------------------------------------- --- --------------------e------------'--------------- Remodeling --- ---------- Remodeling and/or repairing (describe)_________________ '-------------------- ------- E' ,.................... . .......... ... _.;______________-__•_•__-•---•_--__--. __. --__--_.._.___ i � epi ------------------- ---------------------------- I hereb rf that I have •prepared this application and tha+'tlie work will be done`in accordance with San Joaquin Coun .-, - - - Y P P PP q ' i ordinance Sate aws,,and rules and regulations of the San/Joaquin Local Health District. . _ _ (Signed) - ------------------------------ ;_ .(Owner and/or Contract f -- ------•--• ---•- $y_______________ .�� ____(Titl _____- •___.- s ____._. .... �in _________________ ______ ,__ (Plot plan, showing size of lot, location of son to well , buildings, etc.,°can be placed on reverwside)I FOR DEPARTMENT USE ONLY = °` p APPLICATION ACCEPTED $Y___ -.- - .. . ---------- DAr -l--13-e 71 ----------------_- _�__.__ ___x_.._/„l�_______r_ _- .._... .. REVIEWED BY_------------- I ------------------------------- ----------- ° pR =- BUILDING PERMIT ISSUED-------------------------------------------------:-------` ------------=-,-----------•--•----------- lw --'=--------,---------------"..-------------------------- Alterations and/or recommendations.......... ------------------------------------------------ - -----•----•-:---- [ --------------------• _ -------------------------- _... .. ---- -- - - - - F.: ---------------------•_--__-_--___-___-__--___--.__-•----_-_-_•--_---_-_______.____-_________----__-.-. .. --- j FINAL INSPECTION BY:----- ---------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street i 14 Stockton, California Lodi, California Manteca, California Tracy, California FS-9-2M Revised 8.'59 F.P.Co.