SU0011942 - Laserfiche WebLink

Home Browse Search

a,FOR OFFICE USE: ....................:.................------. - 1 v APPLICATION FOR SANITATION PERMIT Permit No. 1l .-aar�9�- :^n......... ...........................- (Complete in Duplicate) ..................... ... This Permit Expires 1 Year From Date Issued Date Issued ...-.3-�0.?� - - - I Application is hereby made to the San Joaquin Local Health District for a permit to construct anti install the work herein described. This applica+ion is made in compliance with County Ordinance�o. 549. .tt lO Sr15 w• �,E..4.;r7 G.r�!E/' [ L...: � / �•' JOB ADDRESS AN LOC 0As. JOB --.......�- - 7 Owner's Name....... kk. .... _�....--...�......... (�? :.L ':--..- - -.................. Phone....-- -.................... rypI . --- . ...... ..........-.-._........._........... ---•----------------- lice Apartment House ❑Commercial ❑ Trailer Court ❑ Motel ❑ Other-❑ u 81 Ou„�.�,_ __ .......... Contractor's Name............._ --- I II • Instelletion will serve: Resid I Number of living units _1... Number of bedrooms .2-Number of baths ..7-Lot size ._......-� ............ .......................... ( Water Supply: Public cyst l 1I ❑ Community system ❑ Private El�_Depth to Water Table .10... ft.^ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay❑ Adobe 0--Hardpan ❑ r -•Previous-Appliw#ion.Mede: Jf-yes,date..... . ......._..) No [• '^New Construction: Yes El—No C1 FNA/VA: Yes ❑ No El TYPE OF INSTALLATION ND SPECIFICATIONS: (No septic tank or ce�spool permitted'if.public sewer is available within 200 feet.) 1 ,t Septicnk: P&- Distance�Oom nearest well-----._--.-_---Distance from foundation-_.-...-__-._.Material-_--..._..:......................_............ Cp fx6f1 No. of c mpartments..............._.........Size......._.....__-.----------Liquid depth....._-_.-.............Capacity.__..-----�--. t5 ' Disposal Field: Distance from nearest well-. .0- Distance from foundatio ..�V.........Distance to nearest Vine-.--4S...-_.... [f Numberff lines,.. '�-.' Length of each line--..---- 0... Width of trench..---. .. al Type of iterme+erial :...IS4. .Depth of filter materiel......1-,4r..........Total length....... - - ..... - i Seepage Pit: Distance'�to nearest well......................Distance from foundation..............._...Distance to nearest lot line._...._......_ ❑ Number,Df pits......................Lining material.......................Size: Diameter.......................Depth................................. Cesspool: Distance from nearest well.................Distance from foundation....................Lining material..........._........................ :. �❑ Size: Dia eter.......................'-•-------....Depth..:------r-----------V-..-------.............Liquid Capacity.--•----------'-------gals. 4e - Privy Distance from nearest well.....................................m...........Distance from nearest building...................................... ElDistance to nearest lot line.---------_.......................:................_................_:--------------....................-.-...._....................... F Remodeling and/or repairing (describe)........... �1 4w.N.-T0....�L{.5.jL#41r..ZYSxz�•.-----------------........_._..._...___ � I I 1 hereby certify that l hlave prepared this application and that the work will be done in accordance with San Joaquin County ordinances, St/ate laws, and ulea and regulations of the San Joaquin Local Health District. (Signed..... i[iA�:.. I. .............................._(Owner and/or Contractor) I( :............ .. --- -:�.-.... ...tea--.._ (Plot plan, showing size of lo;, location of•system in relation to wets;buildings, etc., can be placed on reverse side). i FOR DEPA<7MENT USE ONLY jAPPLICATION ACCEPTED. ........... - -- ...-..._......._......................_.._-..... DATE...::..-... .l '-.-.:..........._....._......... ( . REVIEWED BY......-----------. .......: ................... ......... _..--... ...... ........ --.......................... .... .. DATE ...-....-..--............. ...... ... .... ..... ...... - BUILDING PERMIT ISSUE . --------------------•----------------------_._._.........-•----............... DATE._._...... -----------..... . ... - Akerations end/or reeomm ations.... ..... ....._................................................ ......... ...............-.................................------....... ------------------------------------------------------.........................-----.........._.._......._....... -- •----------- --.........'I..............._.....---..... - - - --- -... -_- -_-------_---_---- -le.................._..........................---.....-_ ----.... 14 J €$ FINAL 'INSPECTION � D^ ` 1 Y. AN AQUIN LOCAL HEALTH DISTRICT `' ,�• 160111.tllareltan An. 300 Weq Oak Street 121 Sycamore Street 205 Wert 9th Street �L 5*6100,California Lodi,California -Manteca`,Colifornio Tracy,Colifarnia