17886 - Laserfiche WebLink

Home Browse Search

FOROFFICE USE; i' -' .._ , --------------- ------:n------------------ il--- APPLICATION FOR SANITATION PERMIT Permit No, 1��4__._ -'-----------= ----------------- ------ -- --- {Complete in Duplicate) ---- --_ This Permit Ex fres 41 Year From Date Issued Date Issued.___,, / j Application is hereby made to the San Joaquin Local Health District for a permit to construct and install tche wok herein described. This application is m d in compliance-with County Ordinance No. 549. ��`_`_RQ� __ , l SSJOB ADDRESS AND OCA I r - T Pho � . Owner's Name __ _� i� �f-�_ --__ ' y, la --------------------------- Address--------------- .: is Name _-------•- --- - ------"------ Phone----- ..��. - -------------- Contractor's Installation will'serve:- Residen e Apartment,House- Commercial P ❑ ❑ Trailer Court ❑ Motel ❑ Other..'❑ a Number of living uni s'��r_ Number of bedroo Number of baths _/___ Lot size __________________________ Water Supply: Public syste_mQ' Community system ❑ Private ❑ Depth to Water Table 7_. ft. Character of soil to a depth=of 3 �et: Sand ®''Gravel E] Sandy Loam L] Clay Loam E] Clay E] Adobe❑i Hardpan ❑ . I: Previous Application M:ade:F"{If yes,date---_-----------___.] Noe, o New Construction: Yes No`❑ FHA/VA: Yes ❑ No TYPE-OF INSTALLATION AND 'SPECIFICATIONS: Y�~ [No sJ ptic tank or essp I permitted if public sewer is available within 200 feet.) Nostan compartmentsf '� ,.�� Sepfiic k "'� . Distance from nearest well_ -L.__ .Distance from foundation---le---------.Mater ial"' .`}_ r�l/��- -- �' - - -- ii ..___ _ Size__3_,(_ __ X_;"? 71quid de th._,-V ' �l� I q P. Capac,tY "� l Disposal Field: DUmabnece ofrom+nearest w II _..._Distance from foundation.---_ + e� p Length of each line________ _L Distance to nearest lot,line____-___..__... i p � W;dth`yOfgtrench. ------------ - - - YP ; k r1 _, 1V------.Distance•#o nearest ------1 T e of fi ter-matenal__ _- ��:,I�/-- _De th of filter materia!_._.____-_ . Total' len th--------------------- Seepage Pit: Distance to nearest well.___ :►w -----Distance from foundation__.._ I t line_-__-�_ Number of;pits.___ _ Linin rnaferial__,RU�"�__Size: Diameter.__ X ------------------ - --- --- g - -- -- � ---�:�-: --- Depth -- -------------------------- Cesspool: - - Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material---__---- ._.s__ _'___.._ _ ----- ❑ Size: Diameter---------------------=----------------Depth---------- ----------------•------ -----------------Liquid C;apacitY . 'r -------------gals. Distance from nearest well____________ _________________________________Distance-from nearest building __------------------------ Distance -_.:^_------ Distance to nearest lot Eire_____.`-_--____________________________________ - - - ---------------------------------- :Remodeling and/br rep6iring!(describe):--L1O7`F_�._.__Cts 9A(GJF—_---/A(----44Yp-crr-__ - pl.T----147?p ?.--""----f� �I ------ n( is Guess 7h'Rn/ �$' 5---- --- -----------3---�i5 - -------- ._ r. . --------------------------------------------------- ---------------------= - -------- ----- r - _ I hereby certify that I have prepared .th s application and that the work will be done in accordance with San Joaquin County .ordinances, State laws, and 'rule's-and regulations of the San Joaquin Local Health District. , (Signed)-----LV- t„ ------ --- - - - ------(Owner and/or Contractor) -- = (Title) : -"---�, (Piot plan, showing size of Iot,Illocation of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLlCATfON ACCEPTED By...... ------------- DATE-------- f = - REVIEWEDBY---------------------------`----------------------------------------- ----------------------------------------- DATE BlJILD]NG.PERMIT.fSSUED =--- ------------------------------------- -------------- DATE---- - � —....,...a.:. �._.�...,._ . . . , ,�. -. . — , Alterations and or'recomme tions:' - -------------------------------------------------------------------- --- ---------------------------- L -t't�o -Lnrs yF �: F.ttW. �c�G. } �:�v s Tr9�c,�j .. , , ----------- -------------------------•------------------------- -------- ------------------- ------------------------------- _.FINAL INSPEC Date "f SAN JOAQUIN LOCAL HEALTH DISTRICT �} 1601 E.Hazellon Ave. IE 300 West Oak Street Ii 124 Sycamore Street 205 West 9th Street _ 'Cres_ Stockton,California ` Lodi,California Manteca,California Tracy,California �7