Laserfiche WebLink
' APPLICATION FOR SANITATION PERMIT Permit No. _16 <br /> � Uuo�a�1 <br /> (Complete— — '---^ <br /> Date |,�ue6 �..11- ��'��-'. \ <br /> hereby made to the San Joaquin Local Health District�n o permit to construct and install the work hor�m 6esrr6o6.� <br /> T6isapplication |smade incompliance with County Ordinance No 549. <br /> s, 1 ' <br /> Contractor, N .."� /�` ----_-------_.-----.. <br /> Installation will serve: 'Residence �� Apartment [� Commercial [] Trailer Cour [� ��oto| [] Other [] � <br /> ~~ Y <br /> Number of living units/ -j Number of bedrooms -;2. Number of baths 2- Lot size -- . ----_--.'1 <br /> Water Supply: Public system X1 Community- system ' Private [] 'Depth tnr Wafer ft <br /> � <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam E] Cloy Loam Ej Clay Adobe[3 Hardpan 1 <br /> Previous Application Made: Yes E] No � N� �n���� �� � _� �� <br /> + . _ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic fank/mr cesspool permitted if pu�� sewer � araUa�ow�k� 100 feet] . l <br /> . . , ^ <br /> Septic Tpr�:� is,�qnce from nearest well------------------ <br /> Distance from foundation--------------------MuteriaL-_-._- <br /> | <br /> Disposal �,9��� from noan�, w�/-----u/�umo, from foundation'-_''----Distance to nvan,� /or xmu'--'--'� <br /> E] Z�� �� � / Length �f ~� <br /> ` ' �~ <br /> � '/p~ ~' ^^~' ^~'~''~' �~p^' ~' ' -~ <br /> - <br /> "e Pit <br /> gL �Se�pu � �� <br /> ~ <br /> Number_ of pits_------ .~''''-_Lining '_- <br /> Cesspool: Disf noo from nearest� r.' <br /> S D� ` �uua | ` <br /> [] ��� Diameter ��.~..°��-_-�-------Uquid d�� <br /> -----------------------------------------------------I-----------------------------------------------------------------------4-------------------r----------------------------------------- -----------------------------------4! <br /> 1 hereby certify that I have-prepared this application and that the work will-be done in accordance with San Joaquin County <br /> ordinances, St laws; and ri�les and regulations of the San Joaquin Lo�al Health District. <br /> �Yner and/or Contractor) <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED 8Y'-''-' -- ------------------------------------------------------ DATE' - �� -'� <br /> KEV|EVvB} <br /> 8-Y^~�.-l-_�-��/' ..--_-=-'---.-.--.-------.-.'.--.—. --�' <br /> ---�^~_~---o ---------- <br /> --D,'/'Q-E-'---~.-----_'--'------------------------------------- <br /> BUILDING <br /> -��-�._�-_-__—_ <br /> BU|LD|NG PERMIT ISSUED. `--''--''-'-''I'-''-'- ' DATE------------------------------------------------ <br /> L — ' <br /> AKerat�nsan6/wr ,ec�mmon6ations:-- ' --.-_-.---_.--__---.--_--_-_.-- <br /> ____ `°�_-= 0 . - .......... ------------------------------------------------- <br /> ----------------- — �— '�--'---- ' '— — -'-- _------__-.-'_.______._________________ <br /> L'-�"-�.''_'_'''---'''-''— ----------------------- --------------------------''--'''--'''-'''-'-_'''�'---'-'_------ <br /> --'---'-'—_-''''_' '--'''-''''-'''''----_''''-'''`--��--'''---''''�-''-'-''-'_-. <br /> FlNAL-1NBPBCTION-BY:. --'------ ------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> '-- '.SANJOAQU(NLOCALHEALTHDISTNIC7 <br /> � <br /> /oo s^"lh American Street 300 West O*kSf,wat 132 svommnre Street 814 North "r' s+n*m <br /> Stockton, California Lodi, California M"om"*. California nw"'. Cw|m*muES-9-2M ; I Revised W-2100 I <br /> � / <br />