19054 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ------- ------------------------------------- ----- ---------- ------------------------------- ------------- APPLICATION FOR SANITATION PERMITPermit,No. ...... , - ---------------- ------------------------------- ...... (Complete in Duplicate) Date Issued This Permit Expires I Year From Date .Issued - ----------------- -------------------- -- .............. Application is hereby made to the San Joaquin Local H'ealfh District for a permit to construct and install the work herein described. This appli!cation,is..mad in compliance with County Ordinance No. 549." -2-01-2--7.30-01 ktrc-A JOB ADDRESS AND LOCATION--------N ----------- -------45-1------------------ ------------------------- ----- - '. . - ------------- Phone------------- ----------------------- Owner's Name--------i4PRR_1--------- ------------------- --------------- --------- IAddress--------------------- ................... ------------------------------------------------------------------------------------------ Contractor's Name ------------------ Phone-----:----------I-—-------------- ------ Installation will serve: Residence EJ—Apartment House E] Commercial E] Trailer Court [I Motel E] Other El ---)Number of bedrooms 3--- Number of baths;2�_ Lot size ---id 0------ ------------------ Number of living units: 6 Water Supply: Public system El Community system El Private E-'-Depth to Water Table 7 ft. Character of soil to a depth of 3 feet: Sand ir-1ravel C1 Sandy Loam E] Clay Loam El Clay [I Adobe E] Hardpan E] Previous Application Made: (If yes,date------- -------- N o 0---N ew Construction: Yes Rr'qo El FHA/VA-. Yes ❑ Nop— TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic-tank or.cesspool p6mitted.,if,public sewer is"available within 200 feet.) Septic Tank: Distance from nearest well----15Zj�.__Disfarjce from founclatio"n-10-----------maferial_CV_zE�_�.Tj:-7------------ f No. of cornpartm,enfs..- -------- Liquid dep,ih.... ...2___Capacity---- D;sposal Field: Distance from nearest well...570----Distance from foundation-----1-0---- D�iXstance to nearest,lot line----------------- Number of lines-I-----------7----- ---------------Length of each linelqO---rl---10-----Width of french ....3-6- 11----------------- 1 CC X, --- ------- Type of filter_material�%_13 ----.--Depth of filter material-----P7.........Total- length-------------------t/10 ---------- S_t well Distance to nearest lot line-----------------i'� r. Seepage Pit: Distonce'fo nearest -----------------------Disfanfe from foundation------------------- F-1 Number of pits-1----""-------------- Lining material-------.--------------.Size: Diameter----.--.-.-------------Depth__._........._------_......---.__ ' Cesspool: Distance from Lest well-----------------Distance from foundation----------- -------Lining material---__.______--.----._----------._____. ------------z__ --------------------Liquid Capacity----------------------------gals�:',o- ❑ Size: Diameter--------------------------- ------------- _0 I ' 10 Privy: Distance from nearest well.--------------------------------- ------------ -Distance from building----------------------------------------- Distance to nearest ]of line----------------------r---------- ------------ ----------------------------------------------------------------------------------------- ❑ Remodelingand/or repairing [describe):------------------_------------------------------------------------------------------------------------------------------------i ------------------- ------------------------------------------------- ----------------------------------------------------------------------- -------------- ------------------------------------------------------------- ----------------------- Ar --------------------------------------------- ---------I----- ------------------------------------------------ -------- --------------------I ----------------------- ------------------------------ -----------------------------------------------------------------------------------------------I ----------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ----------- - - - -- ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Signed) ---------------------- ------------------------------------- - -----(Owner-and/or Contractor) ------------------- ---------- -------------------------------------------------------------------------------------(Title)-------------------------------- ------ By:- ----------------------------- -- -------- P,lot elan, showin size of'I;St, location of s eril in refs#ion to=wells; buildings,-etc.;can-6e-placed-on-reverse-side). FOR DEPARTMENT USE ONLY ------- APPLICATION ACCEPTED BY--------7-1-71-V-0------------------------------------------------- ------------------- DATE s------------------- j REVIEWED ------------I------- REVIEWED BY----- - ---------------------------- ------------------- ----------------------------------------------------------------------- DATE---------------------------- - - BUILDIN'GkP-ERMIT ISSUED------------------------------------------------------------------------------------ ------------------ DATE.------------------------------------ - ----------_-------- --L.. Ai+erations.,and or recommendations----------- -------------------- - --- -------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------- ........... ---------------I------------------------------ --- ------------------------------_--- ------------------- --------- ------------------------- -------------- --------- ---------- ---------------- ---------------------------------------------------------------------- -------- --------------------------------------------------------- - ------------------ ------------------------....... ----------------------- ------ -------------- ..........I----------------- ------------ ------------------------------- --- -------------• --------------------- ------- ------- ---------------------------- - ------------------------------ ---- - ------------------------------------ FINAL INSPECTION ------------ ------------- SAN kAq UIN LOCAL HEALTH DISTRICT I 1601 E.Hazelton Ave. 300 West Oak Street' 124,SycamoreStreet ..,205 West 9th Street Stocklon,California Lodi,California Manteca,CaliforniaiTracy,California F,P.00.