13735 - Laserfiche WebLink

Home Browse Search

FOR OFFICE E: j ✓ ------ APPLICATION FOR SANITATION PERMIT Permit No. /-3 73-S- ------- ------------------- -- -------------------------- (Complete in Duplicate) G Date Issued This Permit Ex ires 1 Year From Date Issued .r .: .......-.. Application is hereby made to the San 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. 549. JOB ADDRESS AND LOCATION........fa,,-Q------- ��G. , e4Tu��,fl------------•--- Owner's Name. --•L-��t}.'1.-----•-MC.._Av..-rx�`'...-•-------- /' Phone....................... Address---------------!17 0.... /� .7�Q'�----------• �G/�._. — .-r/,; 1- = ................................G--•--------•--- Contractor's Name. -=l— , .F��2f�S _ t` ,�L?G� . Phone.�..�.l46.Q.2 Installation will serve: Residence d Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ----L Number of bedrooms .._L. Number of baths ........ Lot size .........:S- ................... Water Supply: Public system Ae, Community system ❑ Private ❑ Depth to Water Table `- . ft. ` Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay [3 Adobe 4Hardpan ❑ Previous Application Made: (if yes,date--------------------) No New Construction: Yes ❑ No FHA/VA: Yes C-] No El TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Sep ' TanI _ Distance from nearest well,.,..............Distance from foundation--------------------Material................................................. IrS �/- No. of compartments--------------------------Size--------------------------------Liquid depth-------------------------Capacity....................... Dispo al Field: Distance from nearest well_________________Distance from foundation--------------------Distance to nearest lot line._-_-__---_._._.. t"W-/V1 Number of lines-----------------------------------Length of each line-..__. of trench................................... Type of filter material-------------------------Depth of filter material__ __-_-*______-_____Total length_-__--.-------_---:.---_____-_-__-____ S�gp Distance to nearest well---//Lzn/0-__---Distancem foundation.../,/..........Distance to nearest lot line.--,'/4 ... :- yl Number of pits-------- ----------.Lining material----- Cf(�.Size s'Diameter-__•��_��_.__.Depth____�5 � p Cesspool: Distance from nearest well.................Distance from foundation--------------------Lining'material-----_____..__________-._....-------- Q ❑ Size: Diameter-----------------------------------•-Depth----------------------------------------------------Liquid Capacity----------------------------gals. Privy: Distance from nearest well___________________________ ________________Distance from nearest building______-________-___---._._-_-__--_-------. ❑ Distance to nearest lot line-------------------------------------------------------------------------------------•----------------------------------------------------------- nd/or repaRemodeling airing describe x '..._ ---------- ---------------- .............--•--••-------- -------------•-•---------------------------------------------------------------............. -------------------------------------------------------------- -------•-----------•-••--------------------•---------- --------------------------------------------------------------........._.......... ------•---.------------------------------.----------••------..._...-.. I hereby certify that I have pr this application and that the work will 6e done in accordance with San Joaquin County ordinances, State ws, and rul and ulationf of the San Joa `n Local Health District. (Signed)...... - -- ---"- -------C-- ----- --------------------------------------- -- _---- ---- --- ---- -----------------------------------_ Owner and/or Contractor) 6 � By----------------------------------------------------------.---- -------- --------(Title)--- = (Plot plan, showing sire of lot, location of system ' ation to wells, buildi s, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY :-_--_-- --------------- ........ DATE-------------)_At-_Y�'_---•- • - REVIEWEDBY----------------------------_ ------------------------------------------------------------------------ ............... DATE.------•---•----------------------------------------------- BUILDINGPERMIT ISSUED- --- - - ------ --------------•----------------------.............................__-...... DATE------------------------------------------------------------- P/r and/or recommendations:----------------------------•--------------------------•--••---____-- -- �. f ---••------ ---- `--� � u------- --------------------------------------•-----------•---.....-----------------------....._.._...- 2� FINAL INSPECTION BY:. ----------------- Date---- _QL-----`-k_- A:: _-------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Strout 300 Wort Oak Street 124 Sycamore Street 205 Wort 911%Strout Stocklon,California Lodi,California Manteca,California Tracy,California ES 9 REVISED 5-59 YM 5-61 ATLAS 4