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f APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) 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. -g 2644 E i- I rasp—Ave'.� 7, ! JOBADDRESS AND LOCATION-------------- s=---------------------------------------------------------- -------------------------------------------------------------------- Owner's Name--------------------------------------John H. Edwards 2-64 1 ----------------------------------------------- --------------------------------------------- Phone E. 1,1arsh' Ave. Stock-ton... C-al- -- - --- - •------------- ---- --- ------- -- -------- -- - -- D A, Parrish &; Sons �nc4 �- �59� ContractorsName------------------------- ------------------------------------------------------� -------------------------------- -- ------ Phone---- -•-----` Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ ' ' 3.0 -------------•- Number of living units: '� Number of bedrooms ['� Number!of baths � Lot size__________b7______.__X...____�._....._--- t Water Supply: Public system 0 Community system ❑ Private ❑ Character of soil to a depth of 3 feet: Sand Gravel Sand Loam Clay Loam Clay Adobe Hardpan P ❑ ❑ Y ❑ Y ❑ Y ❑ � p 9 ' TYPE OF INSTALLATION AND SPECIFICATIONS: , (No septic tank or cesspool permitted if'.pubiic sewer is available whin 200'feet.) -Septic Tank: Distance from..nearest-we, ------------------Distance from 'foundation-_"_ ._'_-._ Material_________________________________________--___._- ❑ No, of compartments------------------ ------Capacity.....-------- ------Size------------------_---------..Liquid depth-------------------------- Cesspool- Distance from nearest well-----------------Distance from,foundation--------------------Lining material-----------------------._-_______-_-_ ❑ .- Size: Diameter------ :=------------.-�-------Depth-----.~- ------------------------------------------ Privy: Distance from nearest we11_____________________•_________________._________Distance from` nearest building --._ ❑ Distance to nearest,laf line---------------------------------------------- Seepage Pit: Distance"to n ae rest ell_____11pnE_____Distance from,foundation__._251_______-Distance fo nearest lot line___3_ _I-____- ® ! ,Number of pits_.�_dri� -__-_Lining=maierial_�on'___ _3'Size: Diameter___3 ��____________.Depth_______ _________R-rpx— Disposal Field-' Distance from nearest well------------------Distance from foundation-----------.______f Disfance 'to nearest lot line---------.__-___ ❑ Number of lines-----------------------------------Length of each line->-'.�° --------------------`Width of +ranch----------------------------------- Type p `�-----------------------tk I s T e o iter materia________________________Det o iter maters Remodeling and/or repairing {describe]:_______________________ ' --ax'a� __nage _ ,y_Se171............................. ti ------------------------- ....__.:... a - a --------------------------------------------------------------------•-------------`------------------•-------------------------------------------=-`------------------------•------••---------------------------------------- e 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..rt+ Si ned 9 ' -_-_D•A. I?�x'Y'a.sh & Sons, Inc. T`"*- 1 .v Owner and/or Contractor ( g } - - - ---------------- :( / ) i�a..i:e's A. ParriF President ----------------------------------------------- By:---------- �c Title} (Plot plans, showing size of lot, location 6Usystem in relation to ells,,kiuilaings, tc., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--------------------------- ter-6 ---- •-------- DATE REVIEWED BY------------------------------- - � - -- --••------------- --------------- ---- -- - - --------------------------------------------------- DATE----- ------- -------�-- ----------------------•--- BUILDiNG PERMIT!ISSUED------------------------------------------------------------------------------------------------------ DATE--------------------------- - -- ----------------------------- Alterations and/or recommendations--- -----------------------------------------------•-----------•---------------------------------------------------------------------------•---`------------- --------------- --------------'------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ -------•-------------------------------------------------=------------------------•-•-----------------------•---------------------------------------------------•--------•-------------------------------------------------- PERMIT No--------- __._i--------- ISSUED _._______-___(Date) FINAL INSPECTION BY:_______------__----_l!__ t Date----------------------t.-- r� -------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES--•9--2M 9-50 W=1639