SU0011942 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: III - __...................-.........—.....�..._ APPLICATION_ FOR-SANITATION PERMIT Permit No. .(a e=rg --------. ---. ...........................---- .._. ... (Complete in Duplicate) ��// .._. This Permit Expires 1 Year From Date Issued Date Issued ....le. .f::ok Application is hereby mad eto the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in 'ompliance with County Ordinance No, 549. 20 9-r•Fa o7 JOB ADDRESS AND LOC TION ..........._.........:_................... 2gN�-� Owner's Name..... ..._........_.ARI..........BU1.LFT...... ............................._...................---- -. ..`._...._.---- Phone.................................... Address,-...._.__............:$..�41)m.--..._k�yyA5w _ N---7�0---__... (�io/c......._ Contrac+or's Name----....... �................Go ' m....................... .. ---- ... Phone__�3i5-��3----- SMAit ...... . (s ❑ ❑ Installafidp will serve: Resi ante ❑. Apartment House ❑ Commercial �' Trailer Court ❑ Motel that Number of living units: ........ Number of bedrooms ........ Number of baths ./..... Lot size ._._9.t3.._Z.L�� Wafer Supply: Public syste r ❑ Community system [I Private [J Depth to Water Table Character of soil to a depth�of 3,feef: Send ❑ Gravel E] Sandy Loam C] Clay Loam[IClay ElAdobe ff-Hardpan ClPrevious Application Made: ![if yes dote._.._ .... ....... ,.l No �I/ New Construction: Yes Q�No ❑ FHA/VA: Yes ❑ No TYPE OF INSTALLATION ND SPECIFICATIONS: (No septic tank or cspool permitted if public sewer is available within 200 feet.) Septic Tank: ICU Distance(from nearest welL•r'.2�Q._._.Distance from foundation-_A0.........Material..._COR1Wt-�j�-. _"_ �xISP No. of mpartments...... _a.............Size...... K.gX/G...._.Liquid depth........Ar?....----------.Capacity....IL442f a,j Cto^ Disposal Field: Distant ,from nearest well...99......Distance from foundatiopp��...:).Q..........Distance to nearest lot line....5........ I [j Number, f lines...... Length of each line........0"01 ...............Wid+h of french-------- ..................... ( Type of; Il+er material P.I9.114�Depth of filter material.....18...._...._Total length._.........�:.._.................._ Seepage Pit: Distance;to nearest well......._.............Distance from foundation....................Distance to nearest lot line.._____.......... ❑ Numbers f pits......................Lining material._---"---.............Size: Diameter.......................Depth................. Cesspool: Disfanc .from nearest well.................Distance from foundation--------------------Lining material................................. ...., ❑ Size: Dilmeter...........------`...................Depth............................................_..-Liquid Capacity-----------.............gals. Prrvy: Distance, tom nearest well.................................................Distance from nearest building.__.�.� ....'i_.`...... ❑ Distance to nearest lot line........................-............................................. I Remodeling and/or repairing (describe):.... -- --` ......................_.....---------•--------...-.._._..........----------..._..-........_....--._.......--............... -..............--------............. I hereby certify that I tlaye prepared this application and that the work will be done in accordance with San Joaquin County T ordinances, State I ws, and'rules and regulations of the San Joaquin Local Health District. (Signed).....' ,. ..........(Owner and/or Contractor) By:..... - ------.................................---------- ...- - --- (Plot plan, showing size of to , location of system in relation to ells, buildings, a+c., can be placed on reverse side). FOR E RTMENT USE ONLY APPLICATION ACCEPTE Y_._.... .. _. ...... ...... -- -- -- ...... ... DATE... . . . -�� - .. ....... ...-.-. REVIEWEDBY...........__.. ....i ... ............-..... _...--........----.............--..............--_........----- DATE..--------- ...---- - -------- ...._......... BUILDING PERMIT ISSU . _........ ...... ...... - _.......__.................................... DhTE...._...- ..................... ...._..-- - Alterations and/or racomm dafions:---------....................................-----__._..._._._.......... ------------------------------- -- - ---- -- - ........:..._... ...........................--------.--------•-•---------------•-----•-----------..._.....-•---.............-------..........--------........-.....,•---------- ----------.------...........--............._ (.........._....._.... - - (I ------------------------------- .................................. ...... - ............ ... - - ..... ..---- ----------------------- FINAL INSPECTIO .. Date.......... .-... :n.la. ................... J IN LOCAL HEALTH DISTRICT t 1601 !.Haraiton Ave. 300 West Oak Street 124 Sycamore Street 205 Wast 91h Street 1 Stockton, Calf" Lodi,Cnlifomia Manteca,Californla Tracy.California e e c P.CO. a