22302 - Laserfiche WebLink

Home Browse Search

FOR QFFICE USE: ad o ------------------ ------------------- --------- - 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. 70 JOB ADDRESS AND LOCATION.... 0t ------------ ------------------- A.T , ------- Owner's-Name--•---------•-PIM_LL` JR-43---------a-Aq% UC-r.------- -- ------C) = --------------- Phone------------------------------------ Address.-----------••- 2 ---------4U-------------------------------•-------------. -- ---------- •----------------------------------------....---- Contractor's Name_-----4kIq-Rl��--------FU L�F-�--------------- - ----- ------- -------------------------------•-------- ------ Phone----.- --------•------------------- Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ i Number of living units: -�.____ Nu ber of bedrooms 3-_ Number of baths mot size �------•-------------• Water Supply: Public system Community system ❑ Private ❑ .Depth to Water Table 1.73_ ft Character of soil to a depth of 3 feet- Sand E---Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: (if yes,date-----------,------- ) No 'Jew Construction: Yes VT"-No ❑ FHA/VA: Yes URI" No ❑ "R TYPE OF-INSTALLATION AND-SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Se O Se tic T k: Distance from nearest well.. 'Distance from foundation-��.t____..._._--Mat rial C CI��-----------. P r No. of compartments___- _—____------Size___ ___ _:p_. _Li uid de th..y _- -..__._..Ca aut — �y --C1 Z? Disposal Field: Distance from nearest well. .W__Distance from fq�unclation.___1_r�___..__.._.Distance to nearest lot line__ . _.._ i Number of lines _____._-P�----._-------Length of each(Tlr e--.__.I.J--- ---,-Width of trench_._.___ �_ Type of filter material._�0--cr.....Depth of filter material ---------Total length---------- __._.__� Seepage Pit: Distance to nearest well..... -_ Distance from foundation------f0--------Distance to nearest lot -Linin material.Rp��._.__ Size: Diameter._ ._ X ❑ Humber of pits--- ---�------ - _--Lining g � �---- --4�_'?-----Depth ---- ------------------------I- .. 4 Cesspool: Distance from nearest well _____ ________Distance from foundation----------------- ..Lining material_._.________._.___---_--------------- ❑ Size: Diameter- ------------- ----------------Depth------------ --------------------- -----------------Liquid Capacity-- - •-gals. Privy: Distance from nearest well_______________________________ __..........._Distance from nearest building------.._.________-___________-__-_--_._- ❑ Distance to nearest lot line ---------- ------------ -- ----------------------------------------------- ----------------------------------- .--------------------- i Remodeling and/or repairing (describe)-------- ------ -- ----- AG - lN ------•-- ----------------------------- ----------------- ...__.. SrF6 LACI= LIMA -- ------------------- -------------- ------------------------------------•------------40Ni _._...Pr- X -------------------------------------------- ---------------------------------------------------- - --------------------------- ----------------------------------------------------------------------------- ---------- --- . . 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. ($ignedl -- _— -- --------------- --------------- ------- ---------- - ---(Owner-and/or.-ContractorJ� ,... B . --- -----(Title).-------------- ---------- ---------- ---.....----- ......... . y �hwinie f olot location of s stem in relation to wells, buildin s, etc., can be laced on reverse side]. (Plot plan, sy g p FOR DEPENT USE ONLY APPLICATION ACCEPTED i3Y.-..._-. Q'-------- -------------------------------------------------------------------------- DATE----------�7_-Y7 4,y ----F----------; REVIEWEDBY--------------------------------------------- ----------- --- --- ---------------------------------------..---- DATE------------------------------------------------- ,yY fBUILDING PERMIT ISSUED------- -- --------------------- -------------------------------------- ------- •------------ DATE------------ ----------------- ---------------------- -. Alterationsand/or recommendations---------------- -------------------------- - ---- ----------------------------------------------------------•-------••----- -----•--------------------------- ----------------------- ----------------------------- - -------------------- ------------------ --- ------- ------------------------------- ----- --------------------------------------------------•------------------------ ----------------------------- ------ -- -------------- -------------•------------------------------------------------ ------- ------ ---- --------- ------------------------------------------ --'--- -�- -------- -- -- - --- ---- --�----- ------------------------------------------------------ -------------- -------- ---- _.---------------•---------- - ------------ --- - ------ - --- ----- . -- _- ---- ----- -- - ------- + FINAL INSPECJION B -- Date. ---- - -------------- 4 SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Ha:*lton Ave. 300 West oak Street 124 Sycamore Street 205 West 91h Street 5iockton,California Lodi. California Mantecar California Tracy,California E.H.9 2M 1-67 Vanguard Press