8206 - Laserfiche WebLink

Home Browse Search

� G --- APPLICATION FOR SANITATION PERMIT Permit No_ ____________ (Complete in Duplicate) Data Issued District for permit to construct and install the work herein described. Applica+ion is hereby made alto the San Joaquin Local Health D This application is made in compliance with County Ordinance N 549. •: � r JOB ADDRESS AND LOCATION. 5 ---40------- -- ---------------•---._.:. ------------- 7 . .� ..._4_ `7'- .- - Y Phone__1` _. Owner's Name------------- -- - --------------------- •- ---��"`"�._'•------------------------------------------••------------------. -------- "'�`?" Address 7TJ f -- ___ -,----------------=----- Phone �f,-_�'l?�k � -� ------ - Contractor s Name----------- ---:'�--• -••--'-�`---�.f-------- '� ----r---`--- ------ - Installation will serve: Residence ,[Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ e Number of living unit __ --- Number of bedrooms __ Number of ba#hs :_ _��j1ot size ___________ _ _t_________ Water Supply: Public system Community system El Private E] Deptrto Water Table ft. Character of soil to a depth of 3 feet: Sa��ew�Construct d E] Gravel ❑ Sandy Loam El Clay Loam C] Clay E] Adobe [�/'i lardpan El Previous Application Mader Yes E] Noion: Yes ❑ No Q� TYPE OF INSTALLATION AND SPECIFICATIONS: ., -^-' LNo septic tank or cl�sspool permitted if public sewer is available within 200 feet.) Spp'ti Ian Distance from nearest well__;__---_.______Distance from foundation--------------------Material-_________:_.---____.__:___----__.._r__._._. . /" No. of (compartments------ -- -- ------ ---Size--------------------------------Liquid depth--------------------------Capacity-----------------:.... sposal Fi Id: Distance from nearest well-______________t Distance from foundation__.___.--_._._._....Distance to nearest lot line.__________._...- �� Type of of lines------- ---------------------------Length of each line--------------------------------Width of tfench_.-------------------------------- '�7 Number yp filter material-------------------------Depth of filter material----------.-.----------Total length----.-----------.-----------------.------- F / ri Seepage Pit: Distanch to nearest well--A.!N�A�___--Distanc from foundation__-. ..�Dis�tarnce to nearest lot line Number of pits----1----------------Lining material_ ------Size: Diameter---,.��_r ----.-Depth - i Cesspool: Distance from nearest well-----------------Distance from foundation.._._._....._____...Lining material------•____._,..___._______._________. El Size: Diameter------------------------------- ------Depth-------------------------- ------ Liquid Capacity- gals. I Distance from nearest buildin Privy: Distance rom rearest well - -_ - Ing..----- ------------ Distance to nearest lot line--------- --•---------------------------------- -----------------------------=-------- �p Remodeling and/or repairing (describe):--------- - ---------------------------------------------------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, a DAY$NIGHT Si ned --------S k-Tartk--Servk&---------- 4lx er rwdg�cr Contractor) (Signed) 9 )-•- 1206 So. Eldorado Ft0 2-T0�4b jUjhX' ' -- y:.-- -------------- , ...---------,----•--5ta�kt-nn--lroti�---- -- - --- - - - � 9 P ) (Plot plan, showing size off lot, lova ion df sys em in relation to w s, buildings. etch, can be laced on reverse side). ,lam. �C FOR DEPARTMENT USE ONLY APPLICATION ACCEPTER BY ----------------- - DATE -------- ---- = REVIEWED BY-----------------, --------- ------ ----- ----------------------- -:------------- _ DATE E--------------- ------ Bi1lLDING PERMIT ISSUED-------- -_---------------- ------- - --- and/or recommendations:------- - --------•--:--- ------•-------------- - ---------- Alterations --• ----- r r - - '-- -------------------------------••-------••------------------------------------•--- _______________________•-.____-_-._-.._.--__:`._________:.._...__-_.__-___._.-----.-------------------------------=------------------."..___._..._.__----...._._-_______-_-_____-. IM ` L -------------------------- Date---`/-- -- - -------- - - - INSPECTION BY:..___-- _ -- -- - ----------------------------- FINALI SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oek Street 132 Sycamore Street 814 North "C" Street {+ Stockton, California Lodi, .California Mianteca, California Tracy, California i k ES--9 145446 arw000 I — alp-