Laserfiche WebLink
APPLICATION FOR SANITATION PERMIT Permit No.A_4y--- ^ <br /> A�mmo�f� �� �upKmafo ~~--- � <br /> � ' ' Duplicate) Date |vmxmJ — <br /> Application is hereby San Joaquin Local Health Districfor a permit to construct and install the work herein descri6ed. <br /> This application is made in compliance with County Ordinance No. 549. ' <br /> Installation will serve: Residence Apartment House mmercial Ej Trailer Court Ll ' Mo�pl El Other <br /> Number of living units: Number of bedrooms umbVerbafhs ---L- Lot size ---------------- <br /> De <br /> Water Supply. Public system El Community system -E] Fri Depth to Wafer Table -------- ft. <br /> ' <br /> Character of soil toadepth of3feet: S d Gmve| F] Sandy Lo ClayLoam El Clay [:) Adobe=__'ardpanE] . <br /> Previous Application Made: Yes E] No ~ New Construction: Yns �n� No [] ' <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: � <br /> (No septick or cesspool permitted if Public Sewer is available within 200 feet.) <br /> Septi� """ Distance from nearest well <br /> LiningDispospVField: Distance from nearest we�LiO_7 Dis+ance-from founclatyio,'i-j/ I'r Distance to nearest 10 li <br /> 4- ------------- <br /> lyr Number of lines------- ength of each Ii tr ------ <br /> Seepage,Pit- Type of filter mate �-.�,k- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation-------------------- <br /> -- <br /> . <br /> --------------------11 . <br /> ' 0 <br /> � ' '~'`~r certify that ' have piepared this applicationthat the work ~~ Joaquin" "= �""= "` *°��rnmn�� � n San Joaquin County ° <br /> / <br /> ordinances, State laws,laws, and rules and regulations of the San Joaquin Local Health District. <br /> [ (S/gnep)- ' <br /> -------------------------------------------------------------------------------------------------------------------------------------------(Owner and/or Contract*, <br /> / By:�------'-------------------_--.—__---_------------------(Title).---.-_—____._____________ <br /> R»lo+ plan, showing size of lot, |o*mti*m of system in relation fowells, 6ui)6ings, o+m~ can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY-'; <br /> DATE <br /> ' BUILDINGPERMIT |SSUED.__.__��J -- __—__---------._-,--_ — --' <br /> Alterations and/or ,ou�mmen6m��my;-----_-----------.------.----_--_---_—.--____�~_______.__._______ <br /> -----------------------------:--------------------- ----------------------------------------------------------------------------------------------------------------------------------—.__--_____.___' <br /> ------------------------------------------------- -----------------—'---_-'''--_-' ------------------------------------------------------------------------------------------------ <br /> --------------------- <br /> ---'--'---'---'''--''--'''---''---''—'----''---'---'----''---''''---'''---'----'--'--'--'--'''--- <br /> FINAL INSPECTION BY:------------------------------------ Date''--''---�----'_—.'__'—_________._ <br /> SAN JJAQU|N LOCAL HEALTH DISTRICT ' <br /> oo Sv"m am"ri"°" str°.x aou West Oak s*,°et oo Sycamore Street o/* North 'C' S+==f <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> � ES-9-2w n'o/ xo"aeJ wcu/ou <br />