Laserfiche WebLink
. '� <br /> � <br /> APPLICATION FOR SANITATION PERMIT Permit No. ` <br /> | <br /> (Complete in Duplicate) Date |sm,o6 4kJA' ' <br /> /0 / <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install tfiewbrk herein <br /> This application is made in cgtnpIiance_wifbPounfy Ordinance No 549. ­11xv, Jr,� <br /> S LOC <br /> J 0 7?Ak-F ----- <br /> ---------------------------------- <br /> ' <br /> A66i ---S-A/)�� ' <br /> - ` <br /> Contmc+n/, N�m�-. ���-�-�� <br /> Installation will serve: Residence 0a'Apartment�ouse E] Commercial E-] Trailer Court [] Motel 0. Other Ej <br /> Number of living units. Number of bed corns Number of baths -1- Lot size --- ----------------------- <br /> Water Supply: Public system El Community �ystern El Private 0-:51-pfh to Wafer Table 4 <br /> Character of soil to a depth of 3 feet: Sand Ej Gravel [I Sandy Loam F] Clay Loam [] Clay E] Adobe &k--Hardpan <br /> Previous Application Made: Yes E] No g?"' New Construction: Yes P��No E] FHA/VA: Yes 0 No F� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or'cesspool permitted if 'pu6lic-sewer,is available within 200 feet.) <br /> Disposal Field: Dis�ance from nearest well-!---------------Distance from foundation--------------------Distance to nearest lot line----------------- <br /> Seepage Pit Disfance,to nearest Dista <br /> oes`pnv.' ' D.".""^" from .~..~'. well-----------------~~.._- from f-_-_ on--------------------Uning -------------------------------------- <br /> El <br /> . .. <br /> El Size: Diameter.---�-----.-._-.Depth----------------------------------------------------Liquid Copucity '-__--_gn!u. ) <br /> Privy: Distance from nearest well------------------------------------------------Distance from nearest building''���__-'--1�---'-�- , ! <br /> [� <br /> Distance tonearestlot line � ] <br /> -~ [` <br /> . . -'` p <br /> , ^._�__�LA.���-K���!- °-- --------------------- ' <br /> ________.__________________________._-'_~_-_-_..__�.-__-.------''-------'��--''- \ <br /> . <br /> --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ' <br /> I hereby certify that I have prepared this and that +he work will be done in accordance with San Joaquin County <br /> ordinances, State OW nd rules and regulations of the San Joaquin Local Health District. <br /> y <br /> (Signo6). -----_--------.---------------------------------------------------_-------..-(Owner and/or C*ofrac+n, <br />' <br /> By:--------------------------------------------------------------------------------------------------`------------------ ------------- '- ''----'--------- <br />| <br /> (Plot o|an. showing o� t� �� |� location of system in relation � <br /> nto � h buildings, etc. placedn <br /> . can be � ��� on reverse side). <br />| ' <br />/ FOR[D6PARTWENT USE ONLY <br /> -----Y-7-Y <br /> - -------------------------- <br />' BU|LD|NG PERMIT ISSUED----------------------------------------- ------------------------------------------------------------ DATE <br /> -----.--.--------------. <br /> Alter*+ionoan6/nr ,ecommen6otino . __'__.'______.____.________ <br /> '—'--'-'----''----''-�'------'---'---'---------'---'-----------------''--'--- <br /> ~ <br /> -'--__-'-'-_-'-_'--_'~^--'''''-'�~'�'''-''�-_'--'-'''''-__''''''--- <br /> ''- <br /> _---_''^ <br /> _-'__-''r <br /> '--''-'-_-.--. <br /> ---. <br /> -' '- - '__.' -_-'''-''-'--'--'-_'''''---'�� <br /> ''--'-_ _----. <br /> -- on� � - � � .� . gFINAL INSPECTION BY:-- -- ��--�--.-------. <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> � <br /> omS� ��" s� ' � \� � s� _ /� ��� S� nww� �' $� <br /> Stockton. California Lodi, California wm"��ca. California Tracy, California <br />