13453 - Laserfiche WebLink

Home Browse Search

� rvn vrrlLt USt: � A --------------------------------------------------------- APPLICATION FOR SANITATION PERMIT Permit No. .---- •--_-- _ (Complete in Duplicate) -------------- --<------ ----- `--------- TFlis permit l:x fres ] Year From Date Issued Date Issued ...O� Application is hereby made to the San Joaquin Local Health District for. .permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. ; ' c � JOB ADDRESS AND LOCATION 916 Owner's Name_-.--pllL_, pr RaP_ 1 = F-- :�".. _�_____ ----------------- Phone.��.-3.-2?�- a - 1,;- Address . .---., �?_':---- �.T�} £.?p----•------- Contractor's Name----- �wR�...._..__.._ ------------ ------ --------•--------•------------- -- - ..............------ -V -----•---- --------•-----•----••---••---- •----- Phone----------------------------------- Installation will serve: lResidence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living;units: Number of bedrooms t �----- ,' -- N ber of baths __!-_-- Lot size -------------3----�G[ ��.--•----------• -- Water' Supply- Public ystemk ❑ Community sy tem ePrivat�e ❑ Depth to Water Table�p ft. Character of soil to a depth of 3 feet: Sand Gravel D Sandy Loam ❑ Clay Loam ❑ Clay E] Adobe [] Hardpan Previous Application Made: (If'yes,date--------------------} 'No �,/ ❑ New Construction: Yes � No ❑ FHA/VA: Yes ❑ No 8 ! TYPE OF INSTALLATION AND SPECIFICATIONS: (Na sep#ic tan`k or cesspool pe muted ifpublic Viewer is availel5fe wi#Lilo` 200 fee#:)--"� -"` °° J Septic nk: Distance.from nearest well___�a--_-_Distance;from foundation -----`------Male Nolof compartmenfs-----2 --- Size_- _ (` _ -_- quid re• l;__+�C�III I -E"]` rF depth-----•--- -- Ca acit �� ------- Disposal Field: Distance from nearest well _,��-.--Distance from foundation..__ ` ------- P Y !• --..._.Distance to nearest lot line-..6- ---------- Le, Nuriber of lines___________ f th of each line_.____ l� Ir __ g f j----- --- Width of trench- - ------------ Type of filter material.- LICKDepth of filter material-----�9-_-_ Total length 1 b -----•------ Seepage Pit: Distance to nearest well---------------------- from foundation___-..._____ Distance to nearest lot line_________________ ❑ Number of pits-----; -_ _. Lining material---- -------- Diameterlk� __.._-.____ f -- - -------------Depth------•-------� •- ------- Cesspool: Distance from nearest well_________________ Distance .from foundation___________________Lining material____-______------- tl Drist: Diameter----- ------------------ -----------Depth---' --•---------------------------------------- - - .`- Liquid Capacity----••---------------------gals. Privy: v trance from nearest well__ _ _ _____ ________•- ._____:_______Distance from nearest building --------- - -------------- Cl Dfianee to nearest lot line---- __ .--'•-------------_- d ------------------•-------------- - --•----------------•-- j----- - Remodeling and/or re airing (describe}_-----_________________-_ ' t ------------------ ------------------------------------------- _- = _: I. hereby certify that I have prepared #his application and f hei ----------------------•----------------------------- -----------------------------�� --•-- n y y p P• hat=the work will be done in accordance with San Joagtiin�Eoun+y ordinances, State laws, Ind rules and regulations of the San Joaquin LocallHealth District. (Signed}. srt�L.l m By- F (Owner and/or Con-tractor] w=-_- .___ -y -- --------- ------------(Title-- ;: :�_;r� .... _-°'4_.. {Plot plan, showing size of Iat, location of s s#em in relation to wells, buiidings--�, a c;, can be )laced on reverse side). { FOR DEPARTMENT USE ONLY r APPL REVIEIWED BY '- = ri ~TION ACCEPTED BY----7__,_ :_ i - p �r._. ' -----------��-----•_-=��---- ----------- ----------------- DATE-------- „BUILDING PERMIT ISSUED------------- = DATE -. - ---------- D and/or recommendations:___._ _ = =' -----------•---------------------------------- Alterations .t�S41�iS _44 - - ----- 1. ;,-_--------- -.- ------------ ------------- ------ FINAL INSPEC�,TIO�r . a --- Dater_ _e:-_._;9 SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street Stockton,California Lodi,California Manteca,California 205 West 9th Street t 1 £5.9 REVISED 9.59 p.p. C0.QM 6.60 - Tracy,California ._.