SR0082244 - Laserfiche WebLink

Home Browse Search

---------------------------------------•------------- _ 1 ......................................... ......... APPLICATION FOR SANITATION PERMIT Permit No. .l / S-.'.1 .................................................. (Complete in Duplicate) Date Issued ...(�.�....6..Z•�— ------------------------------------------------ This Permit Expires i Year From Date Issued Application is hereby made to the San Joaquin Local Heal+ District for a permit to construct and install the work herein described. This application is made i com liance with County Ordinance No. 544. 7 JOB ADDRESS AND LOCATION% _t4 ., -...1 `• ,`_}fiU _. ...-...A_ 1 �....._._.... Owner's Name-----4! -...(7; YX+r7gr�-!_ _ - -t^1..C1.rft-t '" Phone.__..... . _... Address............................................................. .... Contractor's Name c �L* �e'�'^�: •---- ------ �c Q--,!�tJ. .. a Installation will serve: Residence,) Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: !._____ Number of bedrooms -.5'- Number of baths 3�-Ar Lot size rd_'t_.' 'l�............................. Water Supply: Public system ❑ Community system,❑ Private 20 Depth to Water Tablet ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel [] Sandy Loam JU Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ Previous Application Made: (If yes,date-------------- _._.) No New Construction: Yes W No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 204 feet.) AAte�'+ SFptic Tank: Distance from nearest well---5�. ._._Dista nc from foundation__._�.Q*--------Material..w- __ .......................... f� No. of compartments.-A-_..... P .. q p __.____Capacity-41•...._.. . .. Disposal Field: Distance from neore t we!I.,TQ'_._..Distance from foundation./b Distance to nearest lot line...r......... VE Number of lines__ ______. _. ength ofleach line __ . 3s .....Width of trench,_Y.4.�0-.,3..(..•........ Type of filter material .07seAepth of filter`,materia .............Total length--.-*-,................................ Seepage Pit: Distance to nearest well......................Distance from foundation------------------._Distance to nearest lot line................. ❑ Number of pits..... .___Lining material-----------------_.....Size: Diameter.............. ........Depth-----------------._.__________--_ Cesspool: _ Distance from nearest well-----------------Distance from foundation....___..______.__..Lining material................................... ❑ Size: Diameter-------------------- -------•--.•....Depth----•---------------------------•- Liquid Capacity. -----------••-----........gals. Privy: Distance from nearest well..........................I.............. ._____Distance from nearest building........................-__________..._..- ❑ Distance to nearest lot line. ----•-•---•-•-••...............•------•--------------------------.----•--•-•---•----- Remodeling and/or repairing (describe):.......................................................................................... ------------------------------------------------........... ...................---------------------------------------------------------------------------_............................................................................................................................. ... .............................................•-------------- ................... •----•--•---------..._-.-•---_.------•----------•---•------------.-..----•-•-------•---.--_•-.._---------------------------.-.----.. I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Signed).... .............;------ ......... .....................(Owner and/or Contractor) By: --------------------------------------------------------------•---•--•-- ------(Title)............................................. ...- = = (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY_.....__............... ------- DATE_____..___ � - ................ p. _ }.. .............. .. REVIEWEDBY........................... ------............... ............... --------- ......................................... DATE------------------- BUILDING PERMIT ISSUED..................... DAT r�- Alterations and/or recommendations:_...,/�u� J Y 1� -'-------j 2'- �GSlArl_ ..:.f .. _ __r�.ry...tr e+C -----------------------------•---- -------- 2 /'may✓ ...._I•",'k'- �.�._' -- ••}�!.his ----- -2�t�_t __' - ...... 4 -..!----�"`•'^�• -------•-•-------------------•--------------------._---------------- ---••-. •---••--------•.. ............ ..i .._ --------------�Y ------- ----- ••. ..........................•-..--._----•-•-----•------•------------- .................................... ^-- ...... --------------------------------- ,;-�_. -- ----- FINAL INSPECTION BY:I�4 _.. / C Date %Jf d - ....... SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 Wed Oak Street 124 Sycamore Street 205 West 91h Street Stockton, Callfornia Lodi,California Manteca,California Tracy,Colifomla ES 9 REVISED 8-59 =M 5.61 ATLAS