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FOR OFFICE SE: r ,t fl Y - L _AI r______________ APPLICATION FOR SANITATION PERMIT Permit No. ( Sd --------------------------------------------------------- {Complete in Duplicate] w ---...._.__.___-.-..___-___________________.___.- This Permit Expires 1 Year From Date IssuedDate Issued_ Application is hereby made to the San Joaquin Local Healfh District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION. ......733--- orth Laurel Street Owner's Name--------`� _ & Grupe -------------••------ Phone Address----------•-- M Box 1.888 ------- Contractor's NameDeAe-Parrish-&•Sons— Phvne.....---..96a7 Installation will serve: Residence t] Apartment-House [I Commercial El filer Court [Ib I Other ❑ Number of living-units: -------- Number of bedrooms ________ Number of baths ........ Lot size ......._.................................................. .:.. Water Supply: Public system ® Commuriity system ❑ Private ❑ Depth to Water Table .50:ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ (Clay [3Adobe® Hardpan ❑ Pp Y --------------- ❑ ❑ A. Yes a No ❑ W Previous Application Made: (If yes, ) Na New Construction: Yes No FHA/VA. TYPE OF INSTALLATION AND SPtCIFICATIONS: (No septic fanVor cesspool permitted if public sewer is available within 200 feet.) a a.e. .. ..... ,,,,...d - -. Septic Tank: Distance from nearest well-----------------Distance from foundation--------.---------_Material------........................................... r EUsting No. of compartments...................._.----Size_...................----------Liquid depth_................_........Capacity....................... ' Disposal Field: Distance from nearest we!l___------------__Distance from foundation.................._.Distance to nearest lot line................. Ming Number of lines-------------------------,-------_.Length of each line.........---------------------Width of trench................................... �► Type of filter material--_--None------------------Depth of filter material____-,,i_________.__Total length......._____--------------------- �r..__ Seepage Pit: Distance to nearest well--__----------------Distance from foundation....................Distance to nearest lot line............ i ® Number of pits...... ..............Lining material------T"k------Size: Diameter____.33"__._'.......Depth-----25!...-__---------.-•- Cesspool: Distance from nearest well_________________Distance from foundation___._ri-------___:---Lining material----------............................ ❑ Size: Diameter--------------------------_---------Depth----------------------------------------------------Liquid Capacity............................gals. Privy: Distance from nearest well------------------------------------------------_._Distance from nearest building-------------------------- [] Distance to nearest lot line----- -------------------------------------------- -----------•--•-•-------------•----------•-------------------•------•------------- Adding to existing system Remodeling and/or repairing (describe)------------------------------------------------------------------------•--------------------------------------------------------------------------------- ------------------------------------------- , -••----•----------•-•--•...........................................--..................---------- V-------- ------•-- ------ t - . ....,+�..�... I hereby certify fhat I have prepared this application and 6 that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulafions of the San Joaquin Local Health District. td D.A* Parrish & Sons (Si ne g ]•--•---•------------------------------------ ---------------------------------------------------•---------------------------- -----------------------------------(Owner and/or Contractor] Bill Wright t (Title]..............Est. sY= -----------------------------------------•----•..------------------------------•-----••-------•-•------•----- ------ ........ -------------- t (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed an reverse side). t FO DEPARTMENT USE ONLY / APPLICATION ACCEPTED BY_ -- -------- ---------------------------------------------- DATE------ t '�`-- •------------------------- REVIEWED BY....... °� ?_" _,..---- --------------------- ----- -----------------------------•-- - - -- ---- DATE BUILDINGPERMIT ISSUED---- ----------------••------•----------..._._..---------------------------- DATE------------------------------------------------------------- Ar ti sand/or recommendations: ---------------------------------------•-------------•-----•-••----------..... ----------------------------- -------- - �� ----------------------------- --------------------•-----------•---•--------:----•--------------------•----------•-----•-- ------•--------------------------------•-------------------------•------------------- ------------ ------------------------------------------------------------- ------- ...................... F Date_... - 1 .... ------------- FINAL INSPECTION BY: ! SAN JOAQUIN LOCAL HEALTH DISTRICT w 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California'k-. Tracy,California 'e8 9 REVISEO 9-89 PM 5-61 ATLAS