SU0002689 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT k1% '.r.r l'_......... - Permit No. ...................� 1 (cornpWIn* Triplicate) .... ...... .. ..................................... .. -� - - - - Dote Issued �• . ....................................................... This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Health District for o permit to construct and ins'all the work herein y d described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: JOB ADDRESS/LOCATION ............. 3990�'9.. �1o:'t... Wilson Way,__.SLockbon CENSUS TRACT -- -- Owner's Nacre .......................L es.A...P-ariash__....« -------»----------------------------------Phone Address .. 3'28 Ea��..i`,i.Ilsz..AP.a. tslSktt�f�, -itarnia_._......-.--••--.........._..._.. ' az^'�. Soba-.w��A-».._. License# ...«.1-005.71.... Phone 1!46..4007..«_«.._ •0 Contractor's Name....................-V.. -••• "• Installation will serve: Residence❑Apartment House Commercial EJTroiler Court fl x Motel❑Other...............-•-----...««..._.._._. F .. b . " 1 Number of living unity...._..__.._ Number of bedrooms .....—Garbage Grinder ............ Lot Size ....__....____.__•-•••- --- g Water Supply: Public System and name ............... Private�] _... -_ __....__..._..................... ?4 �r Character of soil to a depth of 3 feet: Sand D Silt❑ Clay ❑ Peot❑ Sandy Loam❑ Cloy Loam❑ _ Hardpan❑ Adobe❑ Fill Material Yes..if yes,type SA I34Y.aaY�• ' �'- 33 (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse sided ' " NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is ovailable within 200 feet,) r .........................._- Li uid'De th PACKAGE TREATMENT [ ] SEPTIC TANK Size.....3Xs?E ... q P -- - Q 1. 1Y S fry. r Capacity ..12aQ....... Type p]'f =fit... Material...G4.A�xet�. No. ComportmentsTf? �y , 100r � Y� Distance to nearest: Well .___.....�tl!............. Foundation.........._._._..._...Prop. line ........... ....... r c LEACHING LINE (xj No. of Lines .....One............. Length of each line........6.0................ Total Length--....... . ' Y--:.';_•-' - 'aR` sz r' nrecas ' 1• "rock 'D' Box _.......... 1~ype Filter Material ._............_Depth Filter Material lQrr-•••« 90 ........ Foundation 20r Property Line ... "r r Distance to nearest: Well ................ K SEEPAGE PIT QcJ' Depth ...25!............ Diameter 33.rl........... Number ............................ Rock Filled Yes�] w*No>�[ one yu wv60t Water Table Depth ....... ......... ..................Rock Size ...ls��.._........... 1 8c r 75 t Distonce to nearest: Well ......1SQ•..... ................Foundation .._._..._........... Prop. Line ... .. REPAIR/ADDITION(Prev. Sanitation Permit#............................................ Date ......................._......... ) Y Septic Tank (S eci Requirements) """-..............m ' r+, Disposal Field (Specify Requirements) .............................................•••-••-•-.............................._................. .._ ^-•: - f�. . (Draw existing and required addition on reverse side) +. I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaq r County Ordinances, State Laws, and Rules and Regulations of the San Joaquin local Health District.Horne owner or Been- 2. sed agents signature certifies the following: r t "1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in such manner as to become subject to Workman's Compensation laws of Caiifornla." _- -' Owner Signed Miles..A.....Par�rish.., By......... .......... Title............................••........................_ ............�oth .ned FOR DEPARTMENT USE ONLY , i : K =`' APPLICATION ACCEPTED BY.__......... 8 . ............................ "._............_.. DATE_. .. .t _..s - " t' BUILDING PERMIT ISSUED....................................................................... ..............................DATE.......................................- ?2r .- �"c`: ADDITIONAL COMMENTS. .......................................... ......................................................_..,..... ._................ . .: .•.. ` ......'.................................................. ........................................................................_...............---- a .............. :1. ..... ................................._.__.._..:..Doie...'�'.= .: ...:...... .. . p y: .............. i. Final Ins action b .............. �- ; s:• L c ;'1-DISTRICT +' SAN JOAQUIN LOCAL H_A[T _..'.- E.H. 9 1-'68 Rev.SM ut