18530 - Laserfiche WebLink

Home Browse Search

-------- --------- ------------------------------------- - -------------- ----------------- --------------- APPLICATION FOR SANITATION PERMIT Permit No. - -------------------------------------------------------- (Complete in Duplicate) This Permit Ex Pires I Year From Date issued Date Issued -0- 4/4-C 'Application is hereby made to f 2-o 2-- 230 he San Joaquin Local Health District for a permit to consmict and 'install This applicatj 111 i's made in compliance with County Ordinance No. 549. the work herein described, yj 'S IP E compliance I ----------- ----- JOB ADDRESS AND LOCATI0"V.(-)1_,S.F—= 4 - 1 ) - ------V-F---- ---or---- ------------------ Owner's Name_-------- A/oi�3vA�111114 --------C-----11�1 .... ----- ---- ------------- :�-----------2--- Pho ,g,EiL� r� I ( rie--- Address---------_26 - --,K k- — -IST -Vf-- R' ---S_R ............ -------------------------------------------------- Contractor's Name-- o-�----srtl---(1R7T_H_R'PFt--__,........ Phone Installation will serve: Residence Et'rApartmenf House 0 Commercial 'Ell Trailer Court [I Motel 0 Other E] : Number of living units: J... It Number of bedrooms ;:__ Number of baths Lot size -------------------- ---------------------------------------- Water Supply: Public system El Communityi t S Private ?R�'_Depth to Water Table 7- ft. feet: ! i It Adobe Character of soil to a depth of 3 et: Sand f?Gravel E] Sandy Loam iE] Clay Loam [I Clay El �Ndobe [] Hardpan E] Previous Application Made: (if yes,date- ------- I ---------) No 2!r New Construction. Yes [a�No ❑ FHA/VA: Yes No E] TYPE OF INSTALLATION AND SPECIFICATIONS: a-61-e-�yiWin 2Wf�ef.)" (No sepiicfAnk_6r Ze'sspool'p'ermiiWea�jf�Qji�sewer public sewe s avail Septic. Tank: Distance from nearest weiI___,5_0__Distance from founrd_qfion---10------ �teriaf_.._ No. of compartments------ ------- le _7�is osa Field- ----S;ze-- Liquid cleo --------ii a pacify--I/W.0-0----- W Distance from nearest well.. .5-5-P----Distance from foundation___ _______Distance to nearest-aresf lot lipe--_____-____.___. 411 El Number of lines_-----------�-7 ---------------- ----Length of each line'--- dfh of fren"ch-_36... ------ Wi Type of filter rna I terial--- Depth of filter --i-------Total length-------------116 Seepage Pit: Distance to nearest well-------------- foundation____ I ------------- 171 Number of pits..L --------Distance from Guncidtion--------------------Distance to nearest lot line----------------- 0-1"S.' : Diameter.--,----------- --.----.Deptk---------------------------- --- --------------------Lining material-------------- --- ze Cesspool: Disfa'nce from nearest well-----------------Distance from fou nda}ion--______-_____.._. Lining material-.._---- ---------------------------- ❑ Size: Diameter---t--------•---------- Depth------- -----------�_r -- _f -Liquid Capacity_ Privy: Distance fromnearest ---------------------- ---- -------gals. ' ' well-----------------------------------------------._D..is-'fance from nearest building_.---------_----_---------------I-------- n Distance to nearest lot lire ------------------------------------------------------------ ------------------------- E Remodeling and/or repairing -------------------------------------------------------------------------------------------------------r-------L------------------ ----------------- --------------- ------------------------------------------ ------------------ ----------------------------------------------------------- --------------------------------------------------------------- ------------------•----------------------------------- --------------------------------------------------------------------------------------------j--------------------------------------------------------- ... %415 ---------------------------------------------- I ------------ ----------- -------------------------- -------------------------------------------------- ---------------- ------------- I hereby certify that IJhave prepared this application andifhat the work will`6e done in accordance with San Joaquin County ordinances, State laws, and,'rules nd regulations Of the Sirn'�J'o"'a'q"U"'n'-L'oc'al"Health District. (Signed)- ------------------------------- ----------------------------------------------------- ---------------------(Owner and/or Contractor) y ... ---------------------- ------- - Trl -------- -------- ----- ------------------------------- (Plot plan, showing size of iot.1location lof'system—in.relation fo wells, buildings, efc., can 6e placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY---------- r ��aQ- DATE._ --/, —4(_S� -------------------------- REVIEWED BY------------------------------------- ----------------------------------------------------------------------------------------- DATE------ ---------------- f PERMITISSUED---------- ----------------------------------------------------—-------------------------------------- DATE Alterations and/or recommendations:__.._...__.__...._ --------- ecommendations:----------------- --------- -------------------------I----------1-1----------------------------- - -------------------------------------- ------------------------------------ ------------------------------------------------ -------------------------------------------------------------- -- -----------------I ------------------------------------------------------------------------------------------------------------------------------------ ------------------------- -------------- .................. ------- ------ ---- - -- ------- -------------------------------- ------------------ ---------------------------------- ------- ----- --------------- ---- -------- -----5 ----------- ) _S4 ----- Date---------- ---------- FINAL INSPEC',TN�N B BY _R `111 ---------------- ------------- -------- ........... . SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California F Lodi,California Manteca,California Tracy,California F.Fl.C:Q.