17889 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: -------- ---------- Permit No. ...-f_7.. ..... APPLICATION FOR SANITATION PERMIT :.__ ____ (Complete in Duplicate) Date Issued ._--,��.- -1-41 Ik _ This Permit Expires 1 Year From Date Issued ' ____ -------- ------------------------ A Application Is hereby made to the San tdescribed. f pp y Joaquin Local Health Dist rici:.for a permit to construct an install the work herein This application is made in compliande.vriW-County`.`O�din, ce No-� 449. E d sim A --------------------- JOB ADDRESS AND LOC TkON_��.----- -��P�-.,^� ��"_r-�."-.�,----------------------- -: ----- ----------------- ----- Phone----- ---------------------•---- - II I Owners Name__ w. - 11-i E Address------------' '�` - �' 4 r (� � � Phone------------------------------------ Contractor's Name--------- ---------------------rcla! , ` �Tiailer Court ❑ Motel ❑ Other ❑ Installation will"serve: Residence �Apartmen# House ❑ Commercial"❑ Numberi�of living units: -- .- Number of bedrooms _ . Number of Oaths /-- Lot size ------7y--I--------��-��-�-�---- u' : Water Supply: Public system ❑ Community syst m ❑ Privateeph to Water Table _ .ft, !� Adobe Hardpan ❑ Character of soil to a depth of 4 feet: Sand Gravel ❑ Sandy Loam clay Loam ❑ Clay ❑ ❑ ��,. FHA/VA: Yes �No ❑ Previous Application Made: (If yes,date---------------- TYPE --__---_..,_.. -.-} No New Construction: Yes Ido ❑ TYPEOF INSTALLATION AND SPECIFICATIONS:, -" No is tank or cesspool permitted if public sewer is available wi�hn Z00 fleet. .:,,.... { ;x r 1 - ter I J4 _ ' Distance from nearest well---�- ---_Distanc f,r99m foundati Septic r X X Li uid de th--- �- - Capacity No. of compartments-- ------Size--- q P t d s Disposal F' d: Distance from nearest well___._Distance from fodnddtion---,[-I✓'---"_--_ istance to nearest lot line__- "' Number of lines---------- . _ 0 ¢" Z�._.Width of trench_..._. .------ �— ---------------Length of each line-16--: ------- - y-------- �i Type of filter material--- A-CA---Depth of filter,.mater ._.--------------._Total length-------------/.C�---------------- Seepage Pit: Distance to nearest welL_-_._�__ ._._._-Distance from fouLatio n___________________Distance to nearest lot line.____-.._______- 1,11 p ,,R.. - Lining materia------------ ------ Si�: Diameter---------------------Depth----------- ❑ I�umber of its------------------ - Cesspool: Distance from nearest Wel ^� Dunce from foundation ___________--..Lining material__--------------------------------- Depth � : ------ ----------------Liquid Capacity------------ -------gals. LA ❑ Size: Diameter---- ----- --- P _ _ -- -Distance from,recstell------- Privy-- �f ❑ Distance to nearest lot line__..._---- --------- Id^ ---------------------------- Remodeling and/or repairing (de scr+be�- ---------- --!-- ,,, s:_ = --'..---------�------------------.------------------------------------------------ I -----•---'-----------------•--------------------------------- ------T----- ---:----------------;;; -; -3 x1,..3 -0;4 F _______________________'___-_-__________-_________--_______________-_____._________-.____________________.______.____._--________________._____-__.-___..___..__._ . II ii _________________________-___ {{{ _-.___._-._-_______________ 1 yy li .I ----------------------------------y---------- ---------------------------------------- ; I hereby certify that I havelprepare; this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulationsof the San Joaquin. Local Health District. tXl�_, _.._(Owner and/or Contractor) (Signed)_ % til .. --------------------------- (Plot plan. showing size of lot, location system in relation to wells, buildings, etc., can be placed on reverse sl e). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-- i_:°[ -- DATE. Z . . ---------------- �..[ . DATE i REVIEWEDBY------------------------------t----------"-- ------ BUILDING PERMIT ISSUED----- T`-------- DATE----------- - --.--�- ------- y _ rR - Alterations and/or,recommendation - ---- _ -= ------ - --------------. ----- ---- -------- ----- ._.__ ------ ---- - -- -- ------ ..... wf_ ------- -------------------- --• ----- ----- - i FINAL INSP N BY: --- Date. -- 1- ' SAN JOAQUIN LOCAL HEALTH DISTRICT l 1601 E.Hasellon Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California i F.P.CO. w