Laserfiche WebLink
Permit No. <br /> APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) <br /> Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordina c No. 49. <br /> JOB ADDRESS AND TIO --------�- __- ------ - ( r____ ___ _____ __________ _ ___ ______ <br /> Owner's Name--- - ---- ------- ----------------------------------------------------------------------- Phone------------------------------------ <br /> Address------------- ------ -- - --- <br /> Contractor's Name L. L.= ------ Phon •/__ <br /> - 9 <br /> Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: __-_ Number of bedrooms /_- Number of baths _-/ Lot size __ ,�C�__ _. _________________________________ <br /> Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table��_ ft. <br /> Character of soil to a depth of 3 feet: • Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam [] Clay ❑ Adobe " Hardpan ❑ <br /> Previous Application Made: Yes ❑ No -New Construction: Yes ❑ No� FHA/VA: Yes ❑ No ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: / <br /> (No septic tank or cesspool permitted 1f ublic sewer is available within 200 feet.) r <br /> p �_:Distan e,from foundation '_.___:_____ <br /> Septic nk: Distance from neares' ell -_ ._-- c, +� _.Mate�iai____ <br /> No. of compartme s_______r -____.__Sizeu�_y -�_X�r�__.___Liquid depth_--- __ --__-_Capacity. __...-. <br /> Disposal Field: Distance from Barest weli________________DIstance from foundation__________________Distance to nearest lot line.________________ <br /> ..� �.. <br /> ❑ Number of nes---------------------------`--____--Length of each line-----------------------------.Width of french.__-_-__-_____-___-_--___---_-- <br /> Type of ter material---------- ----- -------Depth of filter material-----------------------Total length---------_-------------_------------------ <br /> Seepage Pit: Dist ce to nearest well_____________!_______Distance from foundation--------------------Distance to nearest lot line__________--__._ ` <br /> ❑ mbar of pits----------------------Lining material---------------- Size: Diameter------------------------Dept h--------•------------------____-- <br /> Cesspool: istance from nearest well-----------------Distance from foundation_________________.Lining material-_______._________.________________ <br /> Size: Diameter: <br />