15782 - Laserfiche WebLink

Home Browse Search

FOUR OFFICE USE: / r APPLICATION POR SANITATION PERMIT Permit No. .l - - z- ------------•------- --------- -3 -------`-----" � (Complete in Duplicate) Date Issued .__.:`�--•- --� r_` /' ;# This Permit Ex tree 1 Year From Date issued .< - finance No. 549. �� ------------------------------------------ A Iication is hereby made,io�Fhe in Joaquin Local Hdealfh District for a permit to construct and ;nstall the work herein described. pP application is made in camphance with Cou ty This app .„ •" �.._ -�_11�S. .. ADDRESS AND LOCATION.-.i_ --•• g�' "` T '" ' f,Fr '1S7I �'r=- ----------••-- one.. - - - ry. ----•- w _ Owners Nome.. 1_05&/y _ '"� - ---- Address. �-E — . rt- -� Pkione... Contractor's Name-_ A �-- - C T 51 Mo ei#❑ Ot er ❑ artment House ❑ Comm�;!V� Trailer C ,0. +•• Installation will serve: I Residence SAP . T'f��I�-•�--'="=`-"�-•-----•-•• -�, ' umber of baths ! Lot size Number of living units: _..�.-_.Number of bedrooms �N }h To Water Table t_3- ft. ..,...J Community system ❑ Private�DeP Adobe❑ Hardpan ❑`1 Water Supply: Public system ❑ 'lay Loa�❑ Clay❑ z Character of soil to a depth of 3 feet SandGravel ❑ Sandy Loam�]' Y FHA/VA: Yes'❑ No 'l "`-}»No New Construction: Yeso ❑ Previous Application Made: (If yes,date-------- -------- TYPE OF INSTALLATION AND SPECIFI ATIQNS:j - l (No septic tank or cesspool'permitted if public'sewer is available within 200 feet.} Ca act � �_ th--------7- ----- P tY-- Septic Tank: Distance fromrneg}st-welly----'----fl28ance from foundation a aria---------•---• �T!/f No. of comps rest well__�Q- - --Distance from foundation_.__.��-- ---Distanc�eoftre c}i�"o ne�orest l ©ot e i Disposal Field: Distance from Lea _ k__Width � f n(C_-� Number of lines__.___.-_. --•- �` Length of each line--------- - J4DD Type filter material... ' -Depth of filter material .__._1 ---- - -Total length.-----••-----j`f� rt— Y i ❑ �------------- Distance to nearest }lot line .__-.. .-:� Distan`a from foundation— Depth . -: ` Seepage Pit: Distance to nearest well Lining material $ze• pr--_ Number of pis------------------ Distancefrom neare"s well'""==`Die a e9 from foundation_________________-.Lining matenal_.--------------- --•--•• s Cesspool: --•------------ I----Liquid Capacity--- - gals Size: Diameter-------------------- I------ -----•-.0 Dept -- I Distance from tear -�:--•-_-•--=-•_==-s-•------�-- Privy: ---------•-•---•---------- ---- Privy. from nearest well- ----------- - Distance to nearest lot in�-------•-•-------- ------ ❑ ----•------•-•-------•---• -•--------••---•-----•--•------11-1.......................... Remodeling and/or repairing (describe):--------------•--- --- ----•--.--------------------------------------------------------------- -----------------•--- ----"-•----•-_ - - - -"�have - - --•------- done - - I I hereby ce ify that prepared this application San d that Joaquin hL cal Health eDistr'ict� accordance with San Joaquin County ordinances, SfaQ laws, and rut and regulations of (Owner end/or Contractor) r (Signed)--- { .Css � 1 ------------------------------------ = (Title) By;..............------------• ------';-.................... , cation of system m relation to wells, buildings, etc., can be placed on reverse side) (Plot plan, showing size of of, la . FOR DEPARTMENT USE ONLY DATE.......5-1:74.... ------------•------------ APPLICATION ACCEPTED BY----- ----- --------- --------_------- - - ---------••- --------------------•------• DATE.._.__....._..----------•- ------------------ -------------•------------ -- REVIEWED BY DAE--_..- rations and or recommend`ations:_...I--..--.--- --- •- ---• BUILDING PERMIT i55UED................. ... -------------------•---- - ... -------------------------- Alfa ,F -----•------ t=i ----------- ----------------------- ---------- ____________ ----------- i ..---------------------- Date------- " ..__. r FINAL INSPECTI' N - --• --------------eL JOAQUIN LOCAL HEALTH DISTRICT 144 Sycamore Street 405 West 9th Street 300 West Oak Simet Tracy,California 138 South A�nfrican Street 300 California Stoekton,Callforeia Lodi,California ES 9 REVISED 9-59 2M 5-62 ATLAS