Laserfiche WebLink
� <br /> FOR OFFICE USE: <br /> ^~ '`~'' —'--'---'r... <br /> APPLICATION FOR -SANIVATION PERMIT Permit No. <br /> 1� Date Issued <br /> - Application is hereby ' Local Health District for mito construct and i daU+he woAherein described, <br /> This application is made in7compliance with Co'V'nfy Ordinance No. 549. <br /> Insf,allation will I serve: Res!j dence (jT^-Apartmant House [] Commercial El Trailer Court El Motel El Other El <br /> Number of living tunits: Number of bedrooms A... Number of baths ... Lot'size ...... ................ <br /> Water Supply: Public systlom El Community system 0 Privafe#2� Depth to Water Table .93-p- ft. <br /> Character of soil'to a depth of 3 feet: ,Sand 0 0-ravel 0 Sandy Loam Ej Clay Loam R'Clay Cj Adobe 0 Hardpan 0 <br /> Previous Application Made: (if yes,doie....................) No R­ Now Construction: Yes Ej�- N, E] FHA/VA: Yes 0 No El <br /> TYPE OFINSTALLATION AND SPECIFICATIONS: <br /> � <br /> (No ,vpfic tank v, c;en9wJ pnnv|t*^J ifpub||vow°w, is available within J <br /> 6|n �O0 {a,� <br /> So Tank: Disfrom ne^,udp�|' Distance from foundation...../P.........Material 7......................... <br /> .� . Cvmv^ No. of' *mpv,+wo"h---� .--.Size--���. �5A_.Liqv@6opjk--!Y - podf�'�� <br /> --. <br /> Disposal Field: U{doo66 ' �� <br /> .. . . . . ., ..--~ - --. ~ . of french <br /> Type oJ �|hvwo+o,�i&o./� � of g�, mofa�aL-11"^'-.Tu+ l length.......... <br /> . <br /> 'Pik <br /> Seepage P�: D�hncv to nvanv�'�pU --~� - ---, from foundation ,'. . Dbhxocoh, nvamst lot line................. <br /> � <br /> [] Num6el- �f pib--.---�L�ing ��o ----'_�r ' 0am�ho�'----�--Duptk''--_-.._--'__ <br /> -~ ^ h L <br /> Cesspool: Distance from nearest °a|L.............. Distance fnomfoundation-------- ...........Lining material <br /> DepthEl Size: Djameter � <br /> . Capacity -� -�---~—. <br /> Privy: o�m^6, 6�,n-����� weU.-�����.��...-�.-��. -- nearesf­ <br /> [] Dkmvco to-nearest lot line...................................V.................._........ <br /> ,_^_________..�________^___ <br /> ' <br /> KomnJokngand/or wp*m`ng ):..-_-------__-----_-----_________'_________________. <br /> ............................................ ----------'-------------'-`'--------^~~-''---------'----^- <br /> ____________ V ~__ ` <br /> '-�' ------�----'----_--_''-'---^-----_---'_---_--'-_.`.__'..-_-'-.- <br /> ----------- ............................-' <br /> I her66y certify the+ lj%ave prepared this applicaflop and that the work will be done in accordance with San Joaquin C*­o­u'nty <br /> ordinances, State laws, and rules and regulations of the San <br /> Jo'equin Local Health District, ` <br /> -------- .......................................................... -(Opoo, uo6/v, ) <br /> (Plot plan, showing size of (of, location of system in rel to wells, buildings, efc,, can be placed on reverse side). <br /> F 0/DEPARTMENT USE ONLY <br /> -- ___ ..... - ................................................................................ <br /> . <br /> FINAL INSPECTION Date----- .................................................. <br /> - <br /> u�A9UINLOCALHE4LYH DISTRICT <br /> 1601 E.xvwov^Aye; woWest Oak Street u*Syc"=°,^o�"/ m,West v/hStreet <br /> o <br /> mwu"�,cotomla Lodi,California Manteca, California Tracy,California , <br /> - '- <br />