9730 - Laserfiche WebLink

Home Browse Search

e-6 ;w* .1 .i k, S �� qr� APPLICATION FC SANITATION PERMIT Permit No. f (Complete in Duplicate) _. q-11 Date Issued Application is hereby made'to' the San"Joaquin Local Health-'District for a permit to construcf and Th is application is made in com fiinstall the work herein described. p ance'with Count y Qr dinance No -549. - 4. "r•T , 4. _ ; JOB ADDRESS AND LOCATION_._-:.-_6S _-N _ Laurel:_-_$t_;____:Sk"n- -- '} Owners Name\ --vulva._enikey_' --------------- - --- _ Phone__ 41 - _ O. �. Address----------- -- --8 ... .. e H = N�.__Amerf_ > �. .# -----=- -----=---------- . - .---------------------------------- Contractor 's .Narne....1 ' ---• ----- I�t41 5� zlr C;1 ' one�HO. �}«''TrT z7 --=----------------------------------------- Instaliation will serve: � Residence- � # � ---------- P •--•------`-- �-•---------- ® > Apart meat House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other'`❑ ° # i Number of living.units- _, _•__ Number f bedrooms :3. Number of-baths __l.-_ Lot sine :4_ Wateh Supply: Public"s stem l ,. �: PPY " y ®`Commun'ity'systerh ❑ "Private ❑ „ Depth'to Water Table .45__ ft• i Character of soil to a tde th of 3.feel: Sand Gravel Sand Loam` 4 p , ❑ ❑ y Clay Loam ❑ Clay ❑ Ad be ] Hardpan E] f Previous Application Made: Yes TYPE OF INSTALLATION AND SF No ¢Cj , New Coflstruc#ao@ ,,,Yoesos�. ,FiA/.�U.A. Y.esQ,. .N,o�� Pp i ❑s p CIFICATIONS ' -; (No septic tank or'cesspool permitted If public sewer is available.within 200 feet.) SepticTank: Distance from nearest we'll------ Distance from foundation_________________ __Materia# ---------------- _____._---__._ .-__--f compartments-------- ize-------•--------------E% LiID No.,o .S Liquid depth ------- Capacity---- ------_ Disposal Field,: Distance from nearest}e l w t.-.Distance from foundation_________ __ ____Distance to nearest loll line ___-.'__.--____- F,XUting Number of lines_ _Lengfih :of each.line _ _.Width of trench____ Type of'filter material': -_ Depth of-filter material``. -____ _!__Total length__-_-_ f. ----( IK Seepage Pit: Distance f nearest well'- X1Q'� --_ Distance from foundation �?�_e.Dista,nce to nearest*111in - pie i ► tlNumber of pits_ 1 Lin ng rnatenal____ 3'OClk__ Size. Diameter__$ __. .____De th_-- Cesspool: Distance_fi om "nearest well---- __.Distance_from foundation_--___ _N__.Linin'9 material_____ -- - th:_-- ----- ❑ Sze iometer___= P - --- '-:Liquid Capacity---- gals- ".t Privy:. Mstace-from nearest well __ _..._Distance from nearest'building____ ___ s � Distance;to'reare'st lot line- t r -- - ------------------------------------ --- ---- ------ --- f------------ -- Remodeling wo�r repairing (describe) --_ 8dding E!pp_e�E _p�� t`'O---e t@,�! lk---qy tEm i S -n, -- - _________________ - r ________ _- •• ___ ---------------- r ------------ -----•-------- --------- ' �'Y _. .___. _____________j__-_-____.- I hereby, cer+Efy that I have prepared this a plicafion,and thaf fhe work will be done,in acc0d na ce with San Joaquin County ordinances,kS+ale laws;TandErules.and-regulaf+ons of7f.he�San-4oaquirn•L-oval-HeaH- District: (signed)------ D �tear1 ■ �,c . a --- ' --' �---- ------ .(Owner and/or Contractor) Perr Wartha:n Yt `= ; = :-- ---------•-y-------------•--------------------------------------`'_ (Title) 14I3e Mgx'o. -------------- (Plot plan, showing size of lof;`Ioca+ion`of system in relation to wells, builclings efc.; can be placed on reverse side). ` _ FOR'DEPARTMENT U5E ONLY-� � �,.. _ APPLICATION ACCEPTED BY " 7 REVIEWED BY_ ------ � # -- _-_ DA TE DA ---. N I ISSUED--------------------- -- ----- -i �. -._ DATE------------ AlferDa�ins and or,recommenda+ions:' l C 1 � / c -------- Uj __ -- -----� --f - -- . I !a� _ 1 amu_2r4-� a. _ �r --- -------------------- V •- FINAL INSPECTION BY:_- �-- _ _---`------- ----- --. - - -Date---- ----------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M . Raviseri 1-57 F-RCO.