13218 - Laserfiche WebLink

Home Browse Search

FGROFRCE USE: -------------- ------------------------------ __--------------------------------------- -------------- APPLICATION FOR SANITATION PERMIT Permit No. _73.. --------------------------------------------------------- (Complete in Duplicate) ------------------------- This Permit Ex ires 1 Year From Date Issued Date Issued .._. Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work hereina 'bed. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND L TIO)V---------------------•--------------------------Ee 52�._ ---------- Owner's Owner's Name-------------- ------ 1 Phone.................................... Address-___-.__ ._ (2- ..... .. ..._... LAi. . Q -------------------------- -•------------------------------------------ Contractor's Name----------------- l' h --------0----------------------------------------------------- .............................--- Phone----------------------------------- Installation will serve: Residence jKL Apartment House,'[:] Commercial�d Trailer Court ❑ Motel ❑ Other ❑ Number of living units: _J--- Number of bedrotims __+ _ Number of baths __--L_ Lot size -----------1�.X.../.�------------------------ Water Supply: Public system ❑ Community system ❑ Private X Depth to Water Table /$-ff. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sam Loam$l Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: (If yes,date- ) No XL New"Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ N0 TYPE OF-INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) i Septic Tank: Distance from nearest well-5010_h,Distance from foundation__/0-!k.!4_!._Materie-------- -------------- _ ______ __ No. of compartments-- _--._ SizeX_5__Xq:...Liquid depth---------- Capacity._._$C !� Disposal Field: Distance from nearest well_5Q-'VAGistance from foundation._lA_R1lI1_.Dista nce to nearest lot Number of -��i_�_-_--_ Length of each line___---- ----�,_Q. Width of trench-- --.-36" T Type of filter material___�� _►raG�Depth of Iter mate rial_-� ,�0 Total length------- ______46S7-.._--- , Seepage Pit: Distance to nearest well----_----------------Distance from foundation-----------------_.Distance to nearest lot line----------------- ❑ Number of pits----------------------Lining material--------`---------------Size: Diameter-------- _------Depth--------------.--------------�-- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material--___-------------------.-__----_---. ❑ Sizer Qiameter--------=--------- ------------------ Depth ---------------------------------------._Liquid Capat.�tY gals. Privy: Distance fr6rn nearest well-------------------------------------------------Distance from nearest building----------- ___---__...._ ❑ Distance to nearest lot line ---------------------------- =---------- -•-----------------------•------------------------- - ,,_, t 1 R modeling and/or re airing describes:---------� P -•---/�--•--��-r-----------tW•B -~-------r x� ---- ,fl!-� � S n d � �C--------�r�_�.l ----�rQ f D }toz q rye P .. e° Y -��-h'-`------ - h gl e r-t-Q ----------- f° -----L�wi �c.r��.f ------- ------ I hereby tify that I have �epared this application and that the work will be done in accordance with San Joaquin County ordinances fate aws, and rules and regulations of the San Joaquin Local Health District. (Signed) . --•---•-- -- ---- 2----------------------------------------------------------Owner and/or Contractor) $y:_ ' ------.-----------------------------------'-_.-----------•------------------------------------•-----------------------(Title)-------------------------------- -- -------------- � (Plot plan, o ing size of lot, location of system in relation to wells, buildings, etc., can be placed an reverse side}. FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY----7r._}_R,_ _f------------------------------- ----------------•----------------------- DATE------- N REVIEWED BY----- ------------- ----------------------- -- ---------------------------------------------------------------------------.... DATE--------------------..... BUILDINGPERMIT ISSUED------------------------------------------------------------------------- --------------------------- DATE------------------------------------------------------------- Alterations and/or recommendations------- -- -- -------------------------------------------------------------------------------------------------------------------------------------------- ---------------- ------ 1 PTS --'i ?.N:?4---- ------- ' ------------------------ I - ` 3 �' ------- D - -.- -- � ---- ------------------------------------------------------- h/ -------------------------------- ---------------------------- FINAL INSPECTI - ------ Date.- �!/-. 31-- 61 � SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street k � Stockton,-Catifornia Lodi,California Manteca,California Tracy,California ES-9 REV15ED a-59 F.P.PO.aM 6.60 t