Laserfiche WebLink
rI� <br /> FOR OFFICE USE: I � z <br /> Ir APPLICATION FOR SANITATION PERMIT �s Permit No. <br /> I )Cemplo4"-`N'plicete) Date 'sued <br /> This Permit Expires T her Frarn Data Issued <br /> Application is hereby made to the Sen Joaquin Local Health L;str;ct fe•a Permit to construct and install the woA herein descaald. <br /> Tnis application is made in compliance with County Ordinance No. 54S. . <br /> JOB ADD,^.ESS LOCATION.....�`...>? _G-. . � ._... _ <br /> „ ` ___'f�;•CeG:�1. .y �I:u7...�1t�r Phare-__— -•— �.. <br /> Owners Neme Z s <br /> +t�/ .... t !t�y. <br /> Address_._._...... �!— � - <br /> � �.✓'. .. ..__... . phone..._........ <br /> 4- <br /> Contractor's Name_. ��r"�- <br /> O <br /> Installation will serve: Residence [Apartment House ❑ Commercial I] Trailer Court (] Motel ❑ Other 0" <br /> ' Numbm of living unite: Number of bedrooms.c?.. . Number of baths .-,;.. Lot size .- <br /> t t- \ <br /> Water Supply: Public system ❑ Community system C] Private Q�Depth to Water Table 1 .. ft. Adobe�Hardpan❑ <br /> Character of sol to a depth of 3 feet: Send[3 Gravel C, Sandy Loam Q Clay Loam❑ ay[I &d01 <br /> Previous <br /> Yes[{ No[IQr- <br /> Previous Application Made: Of yes,dote 1 No C New Construction: Yes ❑ tlo(] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: - <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feat.) <br /> Tank: Distance from nearest »ed Distance from foundation.....-----------.. <br /> h7aterial.____ .__..__._-----_......_._� <br /> �aP L; uid cie fh.._._ Capacity.__.....,_.-.-» <br /> }.q.�v�}' t.lo. of rompartmenrs. . . . Size. ..... _ q p <br /> DlspD fled: );stance from nearest,well SGS fDatence from foundat;gn./U _..Distance to nearest lot line.J... x <br /> Number of I;-es Length of each I e �G - <br /> ._.Width of trench ..w? ---._.—.'—y�TV�`C_ <br /> Type of {Iter material..SrJICC!(' _Depth of Sa¢r mater of i F _. Total length...... <br /> ly Q�_...___.v-- <br /> Seepage Pit: Distance fo nearest wall /h.A• r.. .Dhtamae m foundation._•}.G.__.....Dntay cs fo nearest bt Pme�:5..._... <br /> Number of pits L;-,;ng mal3411, ; G”'t' Si:c: D;amater. Depth...a2.S..._-__ .._� <br /> S'rc Diameter Depth Cosspool: Distance from neatest well. .Distarc• m foundatron Lining .. <br /> material.- ._-.-- ...els. <br /> ❑ L'qu;d Capacity... 9 <br /> .. - <br /> privy; Distance 4om nearest well - <br /> Distance Fran nearos' buib:nq __.. __..__....... <br /> ......_ <br /> O distance to nearest lot 11ne <br /> a <br /> ✓ /fir�e'i' /'-t-sL.� l. �.�iii- .... ....... <br /> Remodeling nodi or repe6;no (dcsc8!;e): <br /> ................................._... <br /> Sin Joe uin Count <br /> I hereb certify fMf I have prepared this appli<eGon and that Ilia work will be dans ;n accordance with q 7 <br /> ordinanc¢t, fe laws. and rules an regulations of tfa-Son Joaquin r oval Health Distr;cf. <br /> [i '�'tL(t4� •li+rt.ar.�— (O(Titto) Ile ner and,ror Contrecfar) <br /> BY: ate.. can be placed on nwne side). <br /> (plot pla,. shew;ng size of bt.location of system in rotation few . build;ngt,FOR DEPARTMENT USE ONLY = <br /> . DATE <br /> APPLICATION ACCEPTED Br . . - DATE . . _. ..... ........... .. <br /> REVIEWED BY ` r DATE <br /> -- <br /> BU;LD:NG PERMIT ISSUED ___ .. . ._ _... . . .. <br /> Alhratiens and/or re- def;ons: •; ��f! .. <br /> �r T <br /> FWAL WSPECT!CT: BY: 41 <br /> t' <br /> . ` SAN JOAQUIN LOCAL HEALTH 131STRICT <br /> Ia01[ 1Nu»ea a.a 300 w•.•oe'•S.«r 124 Srre.,«e Yr.«• 101 wa 9q Sr.rrr <br /> Me•,•w Care..... rw.r.foi,rw.•e <br /> sea [e!e•-. ' <br />