14713 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ------------------ --------------------------- APPLICATION FOR SANITATION 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. JOB ADDRESS AND LOCATION------- --------- --------- • ----------------------------7 C*CKRrC_j- CHaKf ................ Phone"-Y.. Owner's Name...... ...... eA'A# Z------ ---------------- '7-))-65 -TR-0- 'j Address--------------- ...............------------------------------------------------------------------------------------.............................................................. --------------------e4�� - Contractor's Name---------- OAOe------IWO.-Ce,..................................... Phone_/1_i:P-d.yea-7---- u Installation will serve: Residence e Apartment House [I Commercial [] Trailer Court, [] Motel 0 Other E] Number of living units: __/--- Nu m bar of bedrooms _'�.It Number of baths YI-Lot size -----Z-1-70--------'r...A-11 OV.............. Water Supply. Public system El Community system El Private [K Depth to Water Table -------- ft. Character of soil to a depth of 3 feet:' Sand E] Gravel C] Sandy Loam F"'Clay Loam ❑ Clay [] Adobe [3 Hardpan [3 Previous Application Made: (if yes,date-------------------- ) No E!r New Construction: Yes E] No E3" FHA/VA: Yes 0 No El TYPE OF INSTALLATION AND SPECIFICATIONS; (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Spp tic-Tank: Distance from nearest well-----------------Distance from foundation...................Material----------------------------------------- •- No. of compartments--------------------------size---------------- ---------------Liquid depth__------------------ Capacity___----------- ---------- IJ '# t Disposal Field: Distance from nearest well--_: .___Distance from foundation.._-_f_0_.1.___.Distance to nearest lot line--...:I._._. g ------------/-------------------Length of each line--------/5---------------Width, of trench----------/Q-.._.._____...... /ala[7Number of lines--- Type of filter material.-R-Or/<-------Depth of filter material------6P........�Total length-----------45�_..---------------- Seepage Pit: Distance to nearest well----------------------Distance from foundation-------------------Distance to nearest lot line----------------- El Number of pits______________________Lining material:-, \ . __________.Size: --------Depth-------------------•------------- Cesspool: Distance from nearest Dis+anc-e from foundation--------------------Lining material --- -----------_----- 171 Size: Diameter----,---------------------------------Dept h.-.--------------------------------------------------Liquid Capacity-------- -------------gals. - �� - --- Privy: Distance'from nearestbuilding______..____--.._ ---------------------- -welL: -Al ----------- Distance from nearest :Distance t6n`e`res a -f lot line-------------------------------:-----------------------------------------I——------------------------------------------------------------------ Remodeling and/or repairing (describe):------- eVoPP-----/r - --- ........70------- -`Z1_r7Z .... -------- ----------------------------------I----- --------------- ---------------------- ---------------------------------------- ----------- --------------------------------------------------------------- ------------------------------- -----------............. -------------------------------------------------------:-------------------------------------------------------------------------------------------------- I IitI _____---------------------I--------------------------------------------------------------------- ........ _- ------ --- --------- -------- ------ ---------I hereby cert-i-fythat I have prepared.1 this application and that the work will be done in accordancewithSan Joaquin County ordinances, State 16ws,, and rules and regulations of the San Joaquin Local Health District. (Signed) ...... ---------------------------------------(owner and/or Contractor) -------- By:_......... ------------ ---------------------------------- --------- ------------------ -------------- (plot plan. showing`size of lot, location of system in relation to wells, buildings, etc., can.be placed on reverse side). 4P FOR DEPARTMENT USE ONLY -APPLICATION ACCEPTED BY-----_72r_lm`Q_,-------------------------------------------•------------------------ DATE---------- ---- ------- ----------- DATE.--------------------------------- --------------------- REVIEWED BY----------------------------------------------------------a----------------------------------------------------------•-- -------------- ---------------------------------- - BUILDINGPERMIT ISSUED-----------------47771_17n_16a------------------------------------------------------------- DATE------------------------------------- -•--------------------- Alterations --------I------------- Alterations and/or recommendations:---- -----DO-----JV07---------R-1—Zmem ......J013.............. C al lilt_ �Tx .......... TI ------waf5t.....Aac 8.T_rm_?---—----- ------------------ 57R.N5J��----FROM------W-F;:- --W- ja. j��H__Cxw_ _!�Le..............FI-L-JEL_-65------- - -------- -:rl_R,�qA---------------------------------------------------------------------------------------------------------- FINALINSPECTION BY-------------• -- ---------------------------------------------- Date------------------_- -------------------- -------- --------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California 1 Lodi,California Manteca,California Tracy,California ES 9 REYM-CO 8-59 2M 5-61 ATLAS