13794 - Laserfiche WebLink

Home Browse Search

rur,urr LUP,>t: 3 ---- --------------------- ----------------- - ------------------------------------- 'APPLICATION FOR SANITATION PERMIT Permit No. J --------------------- ------------------_-------------- (Complete in Duplicate) ------------ Date Issued -------------------- ------------------------ This Permit Expires I Year From Date Issued Application is hereby made to the Sart Joaquin Local Health District for a permit to construct and in:*11 the work herein described. This application is made in compliance with County Ordinance No. 549. 0 Y 0-5, q&- r 2 /V- JOB ADDRESS LOCATION,- AT .................................. Owner's Name-- - --------------------- -----------------------------------------------I---------------------------- Phone................................... Address......................... ..... Contractor's Name-------------•---- -----------------------------------------------_----------------_----- Phone.---------------._.. .............. Installation will serve: Residence g'.q-Apartment House F] Commercial [-] Trailer Court E) Motel Ej Other ❑ Number of living units: P?... Number of bedrooms _J Number of baths -42-. Lot size Wafer Supply; Public system [-I Community system 0 Private 91'*5epth to Water Table A/0004071t Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam [3 Clay Loam C] Clay.'[ Adobe 93-"Hardpan 0 Previous Application Made: (If yes,date_______.__.______} No.?�r' New Construction- Yes C] No g3--,FHA/VA. Yes E] No Imo. TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well__/41---D' t q from No. of compartments___0? Size_ qdepth__' - _6�- ------- . j -W A: ,capacity. ... .............. -------------- ---Si" M_,_---------------Liquid --------------- FZA�p Disposal Field: Distance from neare t well_,/AR._'_Distance from founclafion../e-i/......Distance to nearest ,;p Width of tr Type of filter mate -i -.1 h of filter mafe 93_*� Number of lines..... 7- Length of each line- ---- --- 6nch_11.4. ---------Dept rial....../-------------Total! length Q._'_____________ Seepage Pit: Distance to nearest well--- 7�-.Distance f f, ndaf ior'-T��sta rice-to-�nea rest lot line_.4;r-' I M f ........... Number of pits...___.Z._._______a'------------Lining rnaterial-;"- ----Size: Diameter -----------DepthV_4_7��........-------- Cesspool: Distance from nearest well_________________Distance from foundation_____-7�S---------Lining material ---------------------------------- 0 Size: Diameter---------------------------------- ...Depth---------------------------------------------�-,_._Liquid Capacity------------- ........ go]$ .7 Privy: Distance from nearest well-------------- -----------------------------------Distance from nearestbuilding------------------------- ............... A I ❑ Distance to nearest lot line----------- -------------------------------- - ---------------------- ------------------ -- ---------------- ------------------- Remodeling and/or repairing (describe):______..: ---*64r�_ -------------- -------------------------------------------------------------------------------------------------- ------------------------------ - - - ------ --------*-------- ---------------------------------------......................................---------------------------------------- -----------------------------------------------__------------------------- --------------------------------- --------------------------- I ---------------------------------*-------*----------------*,*"--*--------------------*---------- -------------------------- .............................. --------------------2�------------------------------------------------------ ---- I ----- I hereby certify that I have prepaied this application and that the work will be done in accordance with San Joaquin County I t. ordinances, State laws, and -rules and rk�eulations of the San Joaquin Local Health District. (Signed)-------------- - -- ------- ---------- --------- .. -------------------------I----------------- ------ Vor Contractor) By:...........................•...._...;_.._..".....____.__-._•-- - -------- --------------------------(Title).... --------- ... .................. in relation to oil&, (Plot plan, showing size Of lot, location of sys rela 411 welts, buildingsi efc., can be.-placed--on-re4irse side). FO_.,9jPARTMENT USE ONLY APPLICATION ACCEPTED(BY ------�_:7:!7�DAT ---------— REVIEWED BY----------------------------11 -------- ' ----- - ----- ----- ---- DATE ---------......................I-------------- - ABUILDING PERMIT ISSUED ----------k------------------------ ........... DATE . . I I Atterations and/or reconmenZ,ions.- - ------------ (--------------------------------------------------------------- ---------------------------------------------------------------------------------------------- I J._'-----------------------------I-------------------------.........r�----------------------_ ..................... ............................................................ I - --- ----- ------------------------------------ --_----------- ------------------!�------ .........---------I......... -- -------- ---------------- -------------- 7 ------- ---------------- ----------------------- ...................... -------------------------------------- -------- f, Bl;FINAL INSPECTION Date_ /----—-- j, -------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak STre*1 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California 6, Tracy,California ES 9 REVISED 0-59 2M 5-61 ATLAS