SU0009414 - Laserfiche WebLink

Home Browse Search

FOR OFF E SE: > -... . 7�E: ...-ate / APPLICATION FOR SANITATION PERMIT Permit No.------------------------------------ ..�. _._.. ------- --------------------------. -- (Complete in Duplicate) / ... ........................... This Permit ExpirYear F em Date Issued Date Issued Application is hereby made to the San Joaquin Local Heal+h District for a permit to construct and install*a work herein dnb esced. This application is made in compliance with County Ordinances NNo./549. 19':r_'0 ,,6/c YXZ JOB ADDRESS AN LOCATION l.� 0._ Or-•-Yj'1� .... .. . ... ......._�P---- .Ill--.-. t �............ / �� x, Owners Name....-. p !+�4!J-_ ._1�4r.Is..S..,.L �iG..A�.r_-.-...-_._ ..............___--.__....__.-.-----. Phone. ,f---• = � Address..--'--............... /-rte rS -_--------- ... - '- ... - - _.........-.. ll Contractor's Name---xf-t�fc. ..1E._ �t i----.- r..J..�.--- !/r.,---- _-........ Phone ��-..rQ 4..._.. Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: .1..... Number of bedrooms_2'_._ Number of baths J.... Lot size ._-—7.j..�..]-...,1_,7._ ..._....... Water Supply: Public system ❑ Community system ❑ Private69—Depth to Water Table fa._r f+. Character of sell to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam❑ Clay Loam ❑ Clay❑ dobe Be-Hardpan❑ Previous Application Made: (If yes,date..............__.) No ❑ New Construction: Yes ❑ No FHA/VA:Yes ❑ No❑ TYPE OF INSTALLATION AND SPECIFICATIONS: �ppfie Yank or cesspool permitted if public sewer is availebk within 200 feet.) tic T Distance from lnearest well-----_-------_-_Distance from foundation....................Material............................._................ Size.._............................Li uid de th-----..._.......---.-_..Capacity No. of compeNments..............._..__-. q R ..._...----------'! os a d: Distance from "serest well�.�...Distance from foundation./�_,..-.....Distance to nearest lot line................ ({ `j Number of linea_-___l_..-.. _._ ._- _Length of each line.- .P�-. .... . Width of trench.-%.�"..X -,X.qi �Or^ Type of filter material.- Depth of filter material........lG.-_-_.....Total length-.�.sef.Q_........K.....� YP I -�- r- P Seepage Pit: Distance to nearest well__..................Distance from foundation.......___.._Distance to nearest lot line-_...-.._._---._ ❑ Number of pits!.....................Lining material..._..................Size: Diameter_....................Depth—___------ Cesspool: Distance from nearest well................Distance from foundation....................Lining material............................... :.... ❑ Size: Diameter -----------------------------------Depth....................................--.............Liquid Capacity---- ---_----------—.-_gals. `t Privy: Distance from nearest well--------_-------------------_----------------Distance from nearest building._...._....—...................... F ❑ Distance to nearest lot line....................................................................._-_....._..-.-._.............._..........................._.... -... C Remodeling and/or repairing (desGribe):... ........................................._-___-....._._........ ..._____..__._......._-...........___......._.... _..—.___......_. ____ _________ ________________ ___________ .........__ ___ _____________._.._,.-___..___...._........-..._........_...._..-......_.....-. t ..............................................._-_ .- ._- ...-_ _-.___. _ _. _.----------- .............................................._....... .............-'----------._..._------------.------------ ----------....._.----------------------__........_......................................... .... I hereby certify het I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances Ste en ks an�`dp� ulafions the Jo uln cal}h District. (Signed(..... .. ..�T... ... . .fir.-.fA J1 -1.. .... ..... .... �----------•--------- -6entrador( GGG �i� By:.............._...,__............-�_I_........... --' - ........._.. - - -r-=f.. -------�Mk)---------------.----------_--- ' - (Plot plan, showing size of Iofl location of system in relafi walk, building a+u, can be plead on reverse side} V FOR D PARTMENT USE ONLY APPLICATION ACCEPTED BY... c _.. .i �A/ --------------__..........-........... DATE..Y-.-L_T. &_�...__.._..---............. REVIEWEDBY........................................................ ................................................... DATE--------- .................................... BUILDING PERMIT ISSUED..........- ........................................... ........................----..... DATE------- .................'............-........ __._ Aherafionsend/or recommendafionsc_....................`--......:.......__.—..................................... ...._..................................................... I ............................................................_.._........_...-'----'----'-----'--... ..._....___...._._._..--'----------...__---•-'----..._.-.._..........---'--�--'-- ---." ..............._................_...._._....; ---------'-'-'---'---'-----........................-...............--------'..............----._....................-................... ...... I FINAL INSPECTION BY:.. lA-`T-..�........ Date....---/ - ---- -- '---'-._:.-..-....-- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South Arnorhan Stmt 300 Wort Oak 5 So 144 sytomor.stmt 405 Wart 9th 51r691 stoma",Colifomta Lodi,Califernla Mento<a,Colifemla Tracy, Colifemla to 9 arVIGtn a-39 !M 9-61 ATLAS