68-437 - Laserfiche WebLink

Home Browse Search

FOR OFFWt--- S"", APPLICATION FOR SANITATION PERMIT 5C 7 �. Permit o- ---------------- ----------- (Complete in Triplicate) Date Issued _ =- -----• This Permit Expires i Year From Date issued - ---- ------- ------ pp - r r ApIth rict for a plication is hereby made 'to in Joaquin compliance cwi h Coueyal Heat0 d Hance Nom549 and ex sting Rulesit to construct and tand Regulations:rein described. This application ;is QWLAND_.CENSUS TRACT JOB ADDRESS/LO TIONsTs lTl_ - Phone.-gs8_~--9-�"~--�-)--------- -NEVI A�.,�------C?- = Owner's Name I NTf _d.., 4-------- ------------ _�_s °--------------- Address f- ota/13 -- - - ----• Phone - ----------------------- - - Contractor's Name --_ Installation will serve: Residence ❑ Apartment House Commercial [railer Court ;❑ Motel ❑Other WBRE-1410—$�-----RF—STRDOr" LotSize ----------------- ------------------------- Number of living units:---__�- Number of bedrooms -_"__.Garbage Grinder -� ------ Private Water Supply: Public System and'home ------------------------------------ --- - ---------------- ---- I Cla. -,�,,.Pa -at.,❑ SandyLoam ❑ Clay Loam -ri Character of soil to a depth'bf 3vfeet: ,, $and„❑: Silt,fl. Y:❑ - -" � _�. - ...T_ - k ,. Hardpan ❑ Adobe'❑ Full Material - C1° lf'ye ;"type j _k,urags,�et must be placed on reverse ide,) f (Plot plan, showing size of,_lot,..-location-of system.-.iia-relation�to-a^�$Ils, I seep p perm r p is. within 200 feet,} , it ermitted if public sewer is - NEW INSTALLATIONI (No septic tank or . - s -' Liquid Depth - PACKAGE TREATMENT { ] SEPTIC TANK,( Size - _ i `I14 _ MateriaiIV -_ No. Compartments 0; _-TYp n- - _ Capanty f 1•- '�; ? ---- FA atio - ine 1 istance�to nearest: `1�'ell --�-- -L� , ---- �. _;-� T Cerigtli of eac4f�4tne------__ LEACHING LINE [ J N6,-6f'Lines -:_-------- t S k, I ,. r, Depth Filter Material --------------------------- ------------ Ty Box ------------ TYPe Filter M tergal. �? D t } �a� , Property Line -------• �-----•--•----- Distance to ne rest:'Well -- -') = _. - 6undati6n ---- i._ Number .......... ----------- Rock Filled ^Yes { No I] SEEPAGE PIT •Depfh . . ------- Diameter f�--------- E i X- "� ____ ____ _______Rock Size f---- "`- ..--- ---------------- ---.v - Water Mable De th ___ -� I_ S '. - -__ F.oundation-_-. - --- Prop. Line l Distance Ito nearest: Well4_---' 1 '- -� N, \ < r - - :i 1 NDate -------------------------------) REPAIR/ADDITION(Prev. Sonitatio n Permit# ----=----r � -------------------------------------------- ------------- Septic Tank (Specify Requirements) --------------------------- ------------------------------- Disposal Field (Specify Requirements -------------------•----------------------- i ---- - ------ ---- = ------------------------------------------- --; ----- +t- -- _. - p=_ "`i _.l ---_ --- - --x - �:. k , (Draw eE istin� and re_uired..addit i.on*n reverse�s de} --------------------- h Son Joaquin ill g, ne in I hereby certify that I have prepared this applicaance ti ulationsn and tof the San Joaquin LocalHealth District.accorHo ertowner or I cen- County Ordinances, State Laws; and Rules and Reg l sed agents signature certifies the following: erson in such manner "I rform certify that in the peance of the work for whieli this permit is issued, I shall not employ any p as to beco sub' t to Wo anusFCompensa.ion laws of California." t Owner ------------------- Signed {If other than ow ------------------ -------- --------- Y ------B -----------------------------------------Her} . l FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY'_ _�t- -- -'-------"----- - ------------------------ ----------------- ----� DATE ---�--�-�-7-`_�L-----�- ------- BUILDING PERMIT ISSUED ----- ----- ----------------------------- ---------- DATE --- ------------------------ ---- ADDITIONAL COMMENTS -------E _ -------- - ' -L--- -- f _ -------•-"------------ ------------------ ----" -- "- -- - : _- -- __ --------- - - - - / ------ --- ----- ----- ------- - Finallnspec SAN JOAQUIN LOCAL HEALTH DISTRICT i E. H. 9 1-'68 Rev. 5M