SR0082111 - Laserfiche WebLink

Home Browse Search

J_ Permit No. VA-1------ 'APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) Date Issued ... 'Joaquin Local Health District for a permit to construct and install the work herein described. gpApplication is hereby made to the San This application is made in compliance'with County Ordinance No. 549. ................ ....................................... JOB ADDRESS AND LOCATPION.. W-10WI-A---- ... ........ ------------------7... ......... .... .......... Pon e.............................. ------------------- ----------- Owner's Name...........IC&........ ....................... t ___t7-----------------------------------------------------------------------------1------ Address__ . ................4--------------------/7- -------------------- _44.4-c-� _ .• ............................... Phone'... Contractor's ___.jCa Other E] Installation will serve: Residence f[ Apartment House El Commercial E3 Trailer Court D Motel 13 L ----------------- rooms .4R.. Number of baths _/....Lot-size Number oflivingunifi:...,._!4. Number of bed '4��Depth'fo'Water Table t--' c system:❑-1 E] Private Water Supply: Publi 0 Community tr Character of soil to a depth'oif 3'ieot:[ Sand ❑ Grav6I Ej Sandy Loam [I ,.Clay Loam El Clay[3 Adobeilardpan 0 Previous Application Made: Yes El INo *—.-"New Construction:. Yes [I No qr1HA/VA: Yes [I No TYPE OF INSTALLATION AND SPECIFICATIONS: J (No septic tank or'cesspool permitted if public sewer is available within 200 feet.) 'Of �A,a? Distance from nearest wel-_�719--------Distance f I Septic Tank: 1�..........Size-- r 8 d,p.th .....Capacity__k�� e..-.Li q u M_1__ No. of'compartrilenfs.... ------ Disposal Field: Distance from nearest well.. . .......�.Distance from foundation..A/10 .......Distance to nearest f lin, Ze.... Lam' th.of each In...............Width of in ...... Leng Number of lines__.� ...... I material....../ .... .Total length-_,.i�14....................... Type of filter at r,i _Depth of.filter Pit: Distance to nearest f Di t ion j0,0___"_.Disti;.c, t6'nearest lot line.-.?.. ....... T 0 lsanc�f fou 113 t See ........Depth------Z..��........ .. N'mb& 'of pit 'Lining materia/l .f.;a alsize, Diameter.,. u ........... . .....Lining material------------------------------------- Cesspool: Distance from nearest well...............:.Distance from foundation._.-_-.dation---------------- k .. ---L- ...... .......:.___1:A_L Liquid Capacity---------------------- 90's Size: Diameter.._.....___............ _ ..._. Depth.................... Privy: Distance from'neb rest"we .......... . . ............. Distance J from nearest building----------------------------------------- ----------- .. .......................... ------------_--- C] Distance-Jo nearest lot lin . ....................................................... ............................---•-------......... Remodeling and/or repairing .... .....J�- ----- t i, - L. r .. . -------------------------*--------4- .............................. ............ I---z...........v--------- ................................................I............ I ------------------- ---------------------------------------------------------------------------------- ..................................................................................................... ..............•--•-•--........_......-- •-•--••..... ..-....................................----- ....... ..... ............ ......................... ......_-------- .................... -p I-1-c.ation..and..that the work will be done in accordance-with-San Joaquin County I hereby certify th�f--1'6ve prepared this application ordinances, State laws, and rules and regujaflons of the San Joaquin Local Health District, Contractor) -------- ------- (Signed)....................... ........ By:....,.... . . ...... ------------ ........(Title)-: ..........(Plot plan, showing size of lot.,location system in.relation to wells; buildings, etc., can be placed on reverse, $90). DEPARTMENT MUSE ONLY _]�------------ APPLICATION ACCEPTED BY.=............................ ................ ------ ------------------ DATEC----------------- "'r� ::_- .................. DATE* -------------------------------------- . ....................... ............ �TREVIEWED BY-----.-•---'............................................. E_: BUILDING PERMIT ISSUED-----------------------•--_- ................D) -------------------:_........ ...... ..................... I ............................ ......................... Alterations and/or recommendatlons:__.................. -- ---------------I............. ---------- ------------------------------ ............... ------ --------- ............. ,t�-- ------------(................. ---------------------------- ... ........ . ...... .. ..... ........ .......... . ..... --1�, . . . L ...................................... ....... ........ .................................................................... .................. . ................................................. ................ 4 . _. r .................................-............-...... ------ --- ------- ............................I...........I....... ....................................... Date..... p ............:=--------- ------- FINAL INSPECTION' BY . ......... SAN.JOAQUiN LOCAL HEALTH DISTRICT '132 Sycamore Street $14 North "C" Street j30 South American Street 30D West Oak Street Tracy, California Stockton. California Lodi, California Manteca, California ES-9-2M Roviseoi'1.57 F.P.00. 'A