SU0001042 SSNL - Laserfiche WebLink

Home Browse Search

• � ' � FOR OFtice use: *40" APPLICATION FOR SANITATION PERMIT .... .. .....................................I......... (Complete in Triplicate) Permit No. ....,.. .. 7. This Permit Expires 1 Year From Oat*Issued Dare Issued . ............. Aopiicarion is hereby made to the San Joaquin i-Occl Health Distrix for a permit to construct and ins-all the worst hereir descr•`bed. This application ;s r.Gde in compliance with County Ordinance No. 549 and existing Rules and Regulations: J08 ADDRESS/LCCATiON ...--� .-�t ••.. - .......... .............. CENSUS TRACT . . Owners Name ... l? �� -. .1.E.(�....,.. ...- .------•---•--------------------------Phane ........ ........ _ Address C, h.. ......... -ry .J�"Tint-+� �.0 ------------•----- -------------- ----------- Contrcctor s home * ........................ Installation will serve: Residence)X-Apartment House Q Commercial f`,'tTrviler Court �} Motel ❑Other ...,................................. Number of living units:...... ..... Number of bedrooms ._- ...._Gorbage Grinder ............ Lot Size 'mater SupPIY: Public System and name -------------- ......................•---.._..,._...,.------------------.--------------------------------------------------Private Choracter of soil to a depth of 3 feet: Sand i] Silt 0 Clay C Peat(_J Sandy Loam Cloy Loom Q Hardpan ❑ Adobe [] Fill Material _ - - -_ If yes, type ..... ................. 'P'Ot plan, showing size of lot, location of system in relation to wells, buildings, eft. must be placed on reverse side-) NEW INSTALLATION: (No septic Tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT ( I SEPTIC TANK O Size...............—---------_......,_..,M.___ Liquid Depth Capacity .................... Type ------------------- Material--------------------- No. Compartments .....•--- ------ Distance to nearest: Well .......----------------------------Foundation .--------------- Prop. Line ----------- ----� c LEACHING LINE ] No. of Lines ------------------- -- Length of each line..--------------......... Total Length 'D' Box I.-----.--- Type Filter Material .-------------------Depth Filter Material ------------- _----------..... Distance ro nearest: Well ........................ Foundation Property tine .----.--.._--.-.--_--- SEEPAGE PIT O Depth ---------.________ Diameter --------------. Numbe- ................__--___.... Rock Filled Yes I] No Water Table Depth ....................----------------------Rock Size-•-----•-------- ---------- (n Distance to nearest: Well ...--------------------------------__-Faundation .................... Prop. Line ._-_--,-� REPAIR/ADDITION Prev. Sanitation Permit .......................•---------- D°f8 ------------------ Septic Tank (Specify Requiremerttsl .._. -.,K LST'k�C -•--- r ......-- . Disposal Field (Specify Requirements) _ - - - ------------ ---- ------------ .1.. .._ -----------_-"-_'•r --- ~3�s'.' if ---------------- - ------- w;';_61` r L �c.rrc�3'_..._ .. w;_6 ng and required addition on reverse side) l hereby certify that 1 have prepared this application and that the work will be done in accordance with San Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local W*cd* OlsMct. Horne owner or licen- sed agents signature certifies the following: "i certify that in rhe performance of the work for which this Perteit is issued, I shall not employ any person in such manner as to become subje4tkip Workman6 Compensation laws of California." 1~ Signed ... ................. 3y ......... ._.................._-------- ......- .'... Titla ....� .(.,a Iif other than owner{ J FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED 3Y .,.../1" - .).. .,.,.........._ - -...-..,.... ............ ., 7 - 77 DATEo .. � . ........ ................ , _DATE.----------------- 3LtLDING PERM17 ISSUED .................. ..... jDDIT:CNAL COMMEN'TE ............ ..... ....... -- - ; .. .... .. ..•.. .................. ............. ... ........................ .. ... ....... .......... .. ....................... ..................s�r. ,..f....�..�........................... .. ............. . ._------------ 1 ....................... inc1 Inspection by: .-----------_------.............. e . J SAN ;OAGUiti LCCA. IAL-,'H DiS R:C 9 '_ 68 qev 5M