Laserfiche WebLink
LICENSE Gt.Y.C.--42 LI C-36 OTHER <br />LAND USE APPLICATION # BUILDING PERMIT # <br />WATER TABLE DEPTH: ha- Zo <br />TYPE OF WORK: <br /> <br />IL ENGINEER DESIGNED r:LTERNATIVE <br /> <br />A DESTRUCTION terl h <br />Li NEW INSTALLATION ' iJ CI REPAIR/ADDITION <br />'Se REPLACEMENT }MI t (It" 101 [1 OUT-OF-SERVICE SEPTIC SYSTEM <br />INSTALLATION WILL SERVE: 0 RESIDENCE <br />NUMBER OF LIVING UNITS: <br />COMMERCIAL <br />UMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />0 OTHER <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAzELToN AVENUE - STOCKTON CA 95205 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS <br />JOB ADDRESS <br />CROSS STREET <br />OWNER NAME <br />OWNER ADDRESS 2 I-1 / L g /te ; <br />CONTRACTOR <br />CONTRACTOR ADDRESS ADDRESS <br />349eo -2. /0 <br />55.0)-1 — r APN <br />0,*° / e <br />y it /-es ki/a. 571e Iva <br />,0 22.)7 e f 'i CITY/STATE/ZIP <br />CITY/ZIP eZ ) 1 / <br />0.30870) 0 PARCEL SIZE <br />EXPIRES 1 YEAR FROM DATE ISSUED <br />TYPE/MFG 3)17 eiy CAPACITY /2G2 gal # OF COMPARTMENTS <br />TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL ft FOUNDATION 5 ft PROPERTY LINE /5 ft <br />SIZE TYPE OF PUMP CI PKG TX PLANT CI SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />.z <br />e.e n ; (.14 3-3 /te <br />PHONE 7 - fo,o' <br />CITY/STATE/ZIP y <br />PHONE <br />SEPTIC TANK <br />GREASE TRAP <br />LIFT STATION <br />NUMBER i17,36 EXPIRATION DATE <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />E PERC TEST # <br />ft FOUNDATION ft PROPERTY LINE <br />ft DEPTH <br />ft FOUNDATION <br />ft FOUNDATION <br /> ft PROPERTY LINE <br />ft DEPTH <br /> ft PROPERTY LINE <br />ft DEPTH <br />ft FOUNDATION ft PROPERTY LINE <br />SIGNED TITLE :SSMICIEUV HIPS # OF LINES LENGTH OF LINES <br />ft FOUNDATION_ ft PROPERTY LINE <br />ft DEPTH <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />LEACH LINES <br /> :[ LEACHING CHAMBERS <br />DISTANCE TO NEAREST WELL <br />Cp&LTER BED WIDTH 45 ft LENGTH -2- 0 <br />DISTANCE TO NEAREST WELL <br />- <br />MOUNDED WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL <br />SUMPS WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL <br />DISPOSAL PONDS WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL <br />SEEPAGE PITS NUMBER WIDTH <br />DISTANCE TO NEAREST WELL <br />ft FOUNDATION ft PROPERTY LINE <br />ft DEPTH <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />MINIM M 48 ADU . ADV NCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />DATE <br />-PAYmEiv <br />RECEI <br /> <br />MAY 2 <br />AN JOA/ N <br />EIV yip" COVN <br />/MA <br /> <br />ALTH L.-. • r L <br />D'PART <br />DEPARTMENT I US, ON Y <br />Application Accepted By Z— Date .1.2-7 /4[9 / /we ?Area Sj/ <br /> <br />Employee 10# <br />Final Inspection By Date 6 17 1 SPECIAL P ERMIT -Approved by <br />Character of Soil to Depth of 3 Ft: it/Sump Soil Character: <br />COMMENTS fnillriss sys-tervi pi-0616W Ca frA) ei 4-0/- hhrs -ft. be freoncithe One,/ <br />fe -u Seel. -14rtes-0--iciet EXk+.113 ?Jul'? •Io lye- if 441"-C1 % nal./ <br />Bok V.-fc rev;seA -to 10 5Q;I4-c'r becJ <br />PE <br />Code <br />SC <br />INFO <br />Received <br />By, <br />CChecli0 Amount <br />Remitted <br />Permit/ Invoice # Permit ID# —Cash <br />g ) 9 a H s" (WV- ,G, 7 1.3 0° - <br />Dati <br />(42- V <br />ServicOeciLiest # <br />S3 tt 2C0`46W <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />202 <br />42-01 <br />4/14/18