SU0002620 - Laserfiche WebLink

Home Browse Search

FOit OFFICE USE: II � l c _ t via - e L j r APPLICATION FOR SANITATION PERMIT Permit No. ..� (Complete in Duplicate) 9..�6.. S This Permit Expires 1 Year From Date Issued Date Issued ....................(.. Application is hereby made to the Sen Joaquin Local Health District for a permit to construct and install The work herein described. This application is made in compliance with County Ordinance No. S49. // JOB ADDRESS AND. ''LOCATION.....If4'W. SAly 1*1..t..........F,j.ft/� . .............................. ................._........ Owner's Name.....W....... ....................... ..... Address.............oR a1.. .........2C �MICV.rx ...... .. . . . . ...... ..........................................................._...... Contractor's Name... f r(- .... S'El�/F�t' Installation will serve: Residence 0 Apartment House 0 Commercial 0 Tra:ier G;rt Iff Motel 0 Other 0 Number of living units: _./. Number of bedrooms . Number of baths /.. Lot size ... ........................... i Water Supply: Public system 0 Community system 0 Priva to R Depth to Water Table V S. ft. Character of soil to a depth of 3 feet: Sand 0 Gravel 0 Sandy Loam 0 Clay Loam 0 Clay 0 Adobe Ig Hardpan 0 Previous Application Made: (if yes.dote I No X New Construction: Yes P( No 0 FHA/VA: Yes'] No 0 TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) y/J� (%1-,7— �� • r /ItC Material../ FF ' (NSA C d VC Septic Tank: Distance from nearest weIL.SC .Distonc9 from foundation. . ... ... .._.. ._..................... Q-� No. of compartments. .s� . Size_3.K5S'Y 9.'_.-_Liquid depth Capacity-20 0�9� r o, ..,Distance to nearest lot lin e.......:;if.. Disposal eld: Distance from nearest well Sd'_. Length from foundation... .. L7 Number of lines. ..- _/. �j Length of each line_9G'.. . _ ...._Width of trench. .07.1e..'............. . Type of filter material.Z, qc c Dcpth of filter material. �B " Total length .... ........... Seepage P't: Distance to nearest all 100 ` f Distance rom foundation._.i:y..�....Distance to nearest lot line..s.�_. ( Number of pits / Lining material.1(ae /f'" Size: Diameter 33TG.,. Depth as.�.... c`1 J Cesspool: D'2tnnte Com nearest well .. ..Distance from foundafbn Lining materiel_ _ .. _................ 0 S:ze: Diameter Depth. .... . Liquid Capacity. ____..... ........gels (!_ Privy: Diatonce from nearest well D;staace from nearest building ..................__.. 0 Distance to neare•.t lo! line ... .._........ ___._. _. . .___. ..... .- ; Remodel rg and/cr rvrert 'ra Idcscrluo]' ._.. __...... ._.. .... ..._. - .. ..I...... L\\\Cp1 I hereby certify that I 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 Health District (Signed). . E"n' //.fr° �l'� 5eis/ErF SZ�V"l " (Owner and/or Contractor( B __ .%/. !{f!�.,1 (Title) y By:- . f� (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed"on reverse side). FOR DEPARTMENT USE ONLY APPLICATIOP. ACCEPTED BY �, C l �x �— ... . DATE. . REVIEWED By - ._ DATE. . . .. .. .. .. ....._ _...._.. BUILDING PERMIT ISSUEDDATE.. .._ .._. .- Alterations end/or recommendations: r ' cIt:AL IP:`.PEC7i0'! 9'i: . . - Date SAN JOAQUIN LOCAL HEALTH DISTRICT 1001 1.M.ubsn a•.. 300 W.0 a.S SSuw 124 Srmner.Sir.., SO!W...via Sen, Sudl.n,Cail.rnla Led.. M..a.,C.10.—. Tr.,v.C.lir.rnln