15679 - Laserfiche WebLink

Home Browse Search

rVKUN-R-E USE; ---------------------------------------- ------------ ------- ----- ----------------------- ------- ----------- APPLICATION FOR SANITATION PERMIT Permit No. --------- . 7 --- ------ ------------ ------------ ---------------- (Complete in Duplicate) ---- --.----- --- --- - - --- -- -- --- From Date Issued Date Issued Application is hereby made This application i to the San Joaquin Local Health District for s made.in compliance with Co ty rdinance No. 549, a permit to construct and install the work herein described. . JOB ADDRESS AND LOCATION ;f--------------- --------- - --------------------- ---------- ---- '_'06 Owner's Name_.. ------------------------------ 01 ,19_12_�--------- ....... ------------ =Address............... ------ ------------- Phone-------------------_------------- ................................ - -• 7 -- --- -------------------------------- -/ ---------------------------------I.......... Contractor's Name--- 14' "- .:e-v 7- ----------------- ------------1_'0_e+h.n----------------------------------- Installation will serve: Residence Apartment House ❑[-] Commercial ❑El Trailer Court El Motel C] other Number of living units. A---- Number of bedrooms ___3-_ Number of baths Lot size1-0 -------- --- ----------------- Water Supply: Public system E] Community system [] private [0 Depth -ro Wafer Table ft. Character of soil to a depth of 3 feet: Sand 0 Gravel C] Sandy Loam [�] Clay Loam 0 Clay ❑ - Adobe El Hard Cj I pan Previous Application Made: (If yes,date_._____..-_---__._) No R1 New Construction: Yes_Z No E] FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest weIIjS-0__'_ Dist from foundation.--/.-#-`--__Maferial_ 1161-� _ DistallQe No. of compartments---- ------------ ---- --•=---Liquid depth---------I/---------------CapacityZk, __"�------- Disposal Field: Distance from nearest welli-0-- ------Distance from foundafion_./9------------Distance to nearest lot'll'ne'-1 Number of fines____,*___________ ----------Length of each line-^ Width of tranch,A-4 ------------- -------------------- --------------- Type of filter materia Depth of filter material'."/,? Y.9 Seepage Pit: Distance to neari 0 --- -----Total lengfh__A. ......--------_-••---------- wel______________________Distance from foundation-------------------Distance to nearest lot line---___-..._____-_ El Number Of pits---#-----------------Lining material---------- ------.Size: Diameter-----------------------Depth--------------------- ----------- I Cesspool: Distance from nearest well--------_------Distance from foundation--------------—_Lining material El Size. Diameter--- I ------------------------------------- I ------------------Depth-------------------- -----------------Depth---------------------I------------------------------Liq"u;d Capacity---------------_----------gals. Privy: Distance from nearest well_______-.______________-_ ____ _._-_._Distance from nearest building---------------- I ------------- --------- 0 Distance to nearest lot line �ingan Rernodel /or repairing fdescribel:------- ----------------------------- -------------------------------------------------------------------------------------------------------------------- -- .........._!�........................---------------------------------------------------------------------------------------------------------------------------------------------:----------------------------------------, -------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- I hereby certify that I have prepared this application and fhat----the-a----work----will----16-e----done'------in...accordance--,-__ _--_-_-----with -S-,&"n- Joaquin----C_ounty "o-_iin'ty ordinances. State s, and rules and I regulations of the San Joaquin Local Health District. Contractor(Signed) ---- ----- ----------------- ------------------------------------ ---------------•-----------.-------(Owner and/or Contractor By=--•------- -----------•-------------•---------.-----•---------------------------------------------------------------•----(Title)-------------- of plan. showing size of lot, location of system in rcilatio'n-to wells, buildings, etc.," can be placed on reverse side). i FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY DATE___�e, REVIEWEDBY ------------------------------------------------------------- ---------------------------------------------------- - - ----------------------------------------------------------------------------------- DATE-------- BUILDING PERMIT ISSUED Alterations and/or recommendations:______.._---•------•------------------ -- ------- 7r_,� ------------- ------- -------- --- ---- ------------------ ----------------------- ------ ---------------- ---------------- -------------------------------------------------------- ----------------------- ----------------------------------------------------------- ----------------------------- - .......... ---------------------------- ---------------- ---------------------------------------------------------------- 41.1 r --------------I--------------------------------------------- FINAL INSPECTION BY:- 4-1- 1-e-ee--------------- Date -- ----j?_ 6 ------------------ --------------- ----------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 724 Sycamore S1h Street Stockton,California Lodi,California Manteca,Cali_ 405 West 9f.—rn-f.--- Tracy,California ES 9 REVISED 8.59 2M 5-62 ATLAS