75-536 - Laserfiche WebLink

Home Browse Search

-- •FOR OFFICE USE; APPLICATION FOR SANITATION PERMIT Permit No. 7s ` 5-3 ........................._...........-. ,I Comploto In Triplicate) ............... ........................................................... This Permit Expires 1 Year from Date Issued Date Issued __. :.,a� . 7S Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application Is madet in compliance with County Ordinance No. 549 and existing Rules and Regulotions: JOB ADDRESS/LOCATION ....... `7.?.. ._' _•___ ...... ' il. .. o ad...............CENSUS TRACT -_-_---_-•--------•-- Owner's Name .....Geor&e••Dew-Dew Ranch Phone Tree Road' - AddressLone -.. ........................ City _ � 9s-2 �' - -- - Contractor's Name Roto------ --ewer.._Ser.....................License # ..x.7.1153.9....--- Phone _1165-2616 Installation will serve: Residence Q Apartmentto se0Commerci .[�Tralhe�Cur Motel QCtther 1- e pom moti e m caretaker ---•....................................•-- Number of living units:...... Number of bedrooms 2..........Garbage Grindery_eS__.._- Lot Size .___-acre2:ge••__ Water Supply: Public System and name ...................................____.....--_--__......_._._ .......... ......_. - .............. IV Character of soil to a depth of 3 feet: Sand Q Silt Q Clay [I Peat E3 Sandy Loam Q Clay Loam 0 1 Hardpan Q Adobe 0 Fill MOterlal:a4.......If yes,type............... ............ (Plot plan, showing size of lot, location of system In relation to wells, buildings, etc. must be placed on reverse side.) y NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT { ] SEPTIC TANK g Sixe_..-.-l� x---5___x_•9''-........__. Liquid Depth ---�}�!............... -... ' Capacity --- ....... T pre_ castMaterial___-gonc.rete Compartments --- 2 yPe Distance to nearest: Well ©_;.........................Foundation _-__ ---------------- Prop. Line ...._-_.........-..... . t] LEACHING LINE [ No. of lines __1.................... Length of:each line-1.0W................. Total length .100.!................. 'D' Box -.;19.---- Type Filter Material .X!9.�k--------Depth Filter Material lgtr T1 - i Distance to nearest: Well ......................:. Foundation 10 5 ....... .......... Property line ------•----•-•----.._,_. SEEPAGE PIT Depth .2-5.!............ Diameter .36.1!........ Number ...-...$---..].- Rork Filled Yes ® No 1 [� Water Fable Depth 68�•........00 ? ' ................Rock Size ' " Y..3'r......--- 5 Distance to nearest: Well ----------------------------------- .... ._•_-1O--t---_---_..... Prop. Line _.__••'....... REPAIR/ADDITION IPrev. Sanitation. Permit# ............................................. Date ...........:...... ) � Septic Tank ;Specify Requirements) -..:__.................. Disposal Field ISpecify Requirements) --------------•--------------........------•---•-•---------.....------------•--- ........................... ------------------- ----------------------- -•------•---------------------- ............-------...... (Draw existing and required addition on reverse side) I hereby certify that 1 have prepared this application and that the work will be done In accordance with San loagvin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin local Health;District. Home owner or licen- sed agents signature certifies the following: P "I certify that in the performance of the work for which this permit is Issued, I shall not e'mploti any person in such manner as to become subject to Workman's Compensation laws of California.,, Signed ---------- -••- - ------ • --- •------ Owner By ----- ------------ - ------ -----•-: Title ......Gontrac.t.6- ------------------------------------ 0 .... f a�i o er) _ PARTMENTUSE ONLY APPLICATION ACCEPTED BY -•--- ----------- -------------------------------------- DATE-- DATE ...... .: ~-J�---�---------- BUILDINGPERMIT ISSUED ------------ ........................----.._.._._..-•-----, ---....----------..._.-..._. -__.___DATE -------- •_...._.-.....---....---._._._.. ADDITIONAL COMMENTS ----------- --------------- ------------------- -- ------•---- ....................... A— -•=----••--- -----_-----------•-- ..................... � r---.. Final Inspection by: __..._.. Date _ . ..� .��`� ........-.- _ ----------- --------- -----� ----•----------------- -- EH 13 24 1-68 itev. 5M SAN JOAQUIN LOCAL HI!ALTH DISTRICT 874 3M