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76-938
EnvironmentalHealth
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HARNEY
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1443
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4200/4300 - Liquid Waste/Water Well Permits
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76-938
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Entry Properties
Last modified
5/15/2019 10:08:36 PM
Creation date
12/2/2017 2:51:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
76-938
STREET_NUMBER
1443
Direction
E
STREET_NAME
HARNEY
STREET_TYPE
LN
City
LODI
SITE_LOCATION
1443 E HARNEY LN
RECEIVED_DATE
11/03/1976
P_LOCATION
HARROLD HARRIS
Supplemental fields
FilePath
\MIGRATIONS\H\HARNEY\1443\76-938.PDF
QuestysFileName
76-938
QuestysRecordID
1744504
QuestysRecordType
12
Tags
EHD - Public
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FOR OFFICE USE- <br /> APPLICATION FOR SANITATION PERMIT <br /> Th li Permit i4tris I Year From Dal*Issued <br /> Application is hereby made to the Son Joaquin' Local-Heo[t�-District-for a per"mit to construct and install the work herein <br /> described. This application is made iii coMpli6n.ce With.County Oidiriance No. 549 and existing Rules and Riigulations- <br /> Installation will serve., --,R#siden& Aportrr rent-House 0,C6mmerclol OTraller Court (3 <br /> Number of living units:_-L.. Number o <br /> f bedrooms ....2_�Garboae Grinder Lot Size -- ---- <br /> ay <br /> a Clay <br /> Character of sail to a depth of 3 feet: (SCond L I Silt,O� I . :-I-Peat Ej Sandy Loom A tm�-�_ <br /> (Plot plan, showing size of_Iot,-location of system In relatio -wells, buildings, etc. must be placed on re. ve <br /> NEW INSTALI.4t*1014:� �'(�o septic toni��o�r seepage pit7plerMlited if public sewer I�available within 200 feet,) <br /> materlo <br /> df <br /> V Box -_--------- erial .....Depth Filter Material <br /> Disposal Pield (Specify Requirements) ............I................................ ........ ------ ------------------------*-------------J, <br /> (Draw existing on�d required addition on reverse side) <br /> I hereby certify that I have prepared-this application and that the-work will be done In accordance wilh Son ciiin <br /> County Ordinances, State Laws, and Home owner Or lice* <br /> sed agents,sig' noture certifies the following- <br /> "I certify that in the performance of the woi� for which-this permit is Issued, I shall not employ any-person In such manner <br /> as to become subject to Workman.s Comp'ens6on laws of California." <br /> Jlf other th7an er) k_J _V, %NJ"_t,—An <br /> ( <br /> APPLICATION ACCEPTED BY ......... 4V ^ <br /> . �-' ���E <br /> ----_------_,---,-� � ��- ---- <br /> -� <br /> � <br /> BUILDING PERMIT ISSUED ..................................................................... ........ ... ............ -..JDAYE -................ ............ ..'...� <br /> ADDITIONALCOMMENTS ----- ___-------------------- ---^------- ........... ...... ----------------------- ------ --------------------------- <br /> ----------------------------------- ---------_-.--_---.---._----'-----------_-__--------' <br /> ---'----.---.--_---- ^ _^------.-----,---'.-.-----.----_--- <br /> ------------'—.---.. -------------------------------------------------------------- .' �� _-.—' <br /> Final Inspection by: ........................ �b��..^�-J�~���W�-�------------------..�o+e ^rx-'��.��.�����--............... <br /> ' E8 13 �� �~�A B�� �� w/r� ' <br /> -� ~ ~' SAN ��AQ�|N ��[�� ����H �����[� "r /° �� <br /> | ' � <br />
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