20954 - Laserfiche WebLink

Home Browse Search

OR OFFICE USE: ` -------------- --------------------------------- p --------------------------------------------------------- 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 compliancfe with County Ordinance No. 549. (07-3 JOB ADDRESS ANDCATION- - ----- _A( ------------ Owner's Name Phone_...-----•-----------------•-------- --•----- Address----------------------- --- C r cx Phone----------------•-----...--- Contractor's Name____ __ �-- -- Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units. ___ -- Number of bedrooms _J_ Number o- baths - -_ Lot size __... ---- - - - Water Supply: Public system El Community system ❑ Private Depth to Water Table -------- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam [Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: (If yes date.__:-------- _--1 No 171 New Construction: Yes El No E] FHA/VA: Yes F1 No El w TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septi aA: Distance from nearest well____-r =___Distance.from foundation------�0____-__-Material_.___C0_)"0 ---------------------------- ----- 1l X u` R r --Capacity p Y Size-19'A X=--------=-------.Liquid ide th-----'�- ------- - ---------------- --- Dispos Field: Distance from nearest well__ _9___-�-.-Distance from foundation /;t...........Distance to nearest lot line_.'--___.__-____ No. of compartments Ize Length of each line--------2'`0-f------------Width of trench----Z._`--.-------------------- I Number of lines--_________-2------------- f' Type of filter material-------'':