16341 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: LC -----_-----------_----------------------------------- ___ APPLICATION FOR SAHTATION PERMIT Permit No. ------------------------ -- --------------------- ------- (Complete in Duplicate) / Date issued ---_-------------------------------------------- This Permit.-Expires 1 Year From Date Issued . .--•----�.:�- -'� 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 made in compliance with County Ordinance No. 549. IP JOB ADDRESS AND�LQ AT N---------- ------------------ �� "'-,--)---------------- ..---- -- ----------- Owner's Name------------- ---- a •----- -••-- �--e•------------- .---Phone--------------------•-------------- 'm Address------ 6, --- -- ..: ----•-•---•-• -- l - � 1----- � Contractor's Name------------------- ----------------- ------------------------------------------------------------------------------------------------------ Phone. --------•------------------------ Installation will serve: Residence l Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ___ Number of bedrooms __ f- Number of baths __-- _ Lot size ____1_-__- x---------------------------------------- Water Supply: Public system ❑ Community system ❑ PrivateA Depth to Water Tabier49 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel Sandy Loam Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ Previous Application Made: (If yes,date-------------------..) NoNew Construction: Yes No ElFHA/VA: Yes E] No'4 r f TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) .�Se tl Tank: Distance from-nearest'-we��ll_rJ_-&_0__ Distan from found tion____-_-1-�