72-105 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT --------- Permit No. 7-'--1- -----_-.�-�'-_�-i------ A (Complete in Triplicate} - 1 L' J Date Issued - '� - --------------------" ------------ --------------------- ------ This Permit Expires 1 Year From Date issued Application is hereby made to the San Joaquin Locale Health District fora permit to construct and install the work herein • his application is made in compliance with County Ordinance Na. 549 and existing Rules and Regulations: desenbed. T pP CENSUS TRACT -------------- Glenwoot�--fid...- - ---- --- - -- -- -- ---- -------- JOB ADDRESS/LOCATION - 4303----E.- ---------- --------- -----Phone ._931—Z824_........- Owner's Name E Gledn�rJooo�d1�R : - - C;tv ---Linden ----- ---- -- -- ---- -------------- -------- ---•--------- -- ------------------------ Phone -464-527 Address ----P7.3 -----•.._ -----------------License # --177883-------- Contractor's Name -. Ikea._SQo R se-Se ery nceffl Apartment House'❑ Commercial OTrailer Court '.❑ Installation will serve: � Motel E]Other -------------------------------------------- der---- ---- ----- --- -------------- -- Ger of living units:..--.-1--- Number of bedrooms ----2-----Garbage Grinder .__-.._-_-- Lot Size --�--�--1��------"-"- -----"""""---- Private Num k - ------- Water ------------------------ --- - Water Supply: Public System and .ame --------------------------------- Peat❑ Sandy Loam ,❑ Clay Loom '[] Character of soil to a depth of 3 feet: Sand:❑ Silt❑ Clay ❑ Hardpan ❑ Adobe'® Fill Material ..------ --- I yes, p wells, buildings, .etcmust be placed on reverse side.) �!0 if lot, location of system in relation to W (Plot plan, showing size o .i# permitted if public sewer is available within 200 feet,} NEW INSTALLATION: (No septic tank or seepage p p --_.- Size-- --------------------•- Liquid Depth -._.---------•- � PACKAGE TREATMENT [ ] SEPTIC TANK [ ] ------------------•"-- T e -_"------- ----- --- Material------------ - --- - No. �Compartments � I Ca acit. -----------------.- YP ----- Pro Line ---------------------- -- ------------------•-- P Y Foundation _-- p' i Distance;to nearest: We ----- -- . - --- ---- Total Length ..._.------- LEACHING LINE [ ) No. of Lines -._- .----------- Length of each line_---------- - - � ---------------•----------•---•-- _ - . Depth filter Materia --------- - D' Box ------------ Type Falter Material ----------- ------ Property Line ► Foundation Distance to nearest: Well ---------------- Rock Filled Yes ❑ No i❑ - Number -- Depth - --- ---- - -- -- Diameter - ---- -------- ------------------ SEEPAGE PIT [ 1Rock Size -------------------------------- k Water Table Depth --------------------------- Line ------------------ ------- .'Foundation Prop. -------------------- jDistanceto nearest: Well ------------------- ----------------) • - -- ------------ REPAIR/ADDITION ----- - Date ----=------------- REPAIR/ADDITION(Prev. Sanitation Permit# -------- t r t See a e--- i --------- Q�,.-and._-bQE--leach-line-.__ �i#.h--a �� 3 P P Septic Tank (Specify Requirements} .._ -- .-_--"-_-- i Disposal Field (Specify Requirements) ---------- ----------- ------------------------- -------------------- I ------------------------------------------ -------- ----- ----------------------------------------=------------------------------------------------------- one in accordance --------------- - (Draw existing and required addition on reverse sa h Son Joaquin hereby certify that I have prepared this application and that he San Joaquin Lhe work will ed Health D'str t Hom'towner or 1 cen- I he y County Ordinances, State Laws, and Rules and Regulations o sed agents signature certifies the following: permit is issued, I shall not employ any person in such manner "I certify that in the performance of the work for which this as to become ub)ect rkman's Compensation laws of California." Owner Signed --... ---- ---- ----- 4 BY �(If t er an owner) F DEPARTMENT USE ONLY DATE -------- 1---- y----------------- APPLICATION ACCEPTED BY . --- --- DATE ----------- ------------------------------- - -------- --------------------------------------------------- BU;LDING PERMIT ISSUED .__. ---- _------------- ADDITIONAL COMMENTS -------•---------- -------- ------------------ ------------------------------ - --- - - ---- -- --------------------------------- - - ---- - - - --- ---- - -- ----- ------- ---- ---- :_- - --- - -- ----------------------------- ----------- - - - -----------.Date .-.� - Final Ins ection b --------- -------------------- SA ---------------- - - - -- SA JOAQUIN LOCAL HEALTH DISTRICT r_ u a 1.'68 Rev. 5M