Laserfiche WebLink
FOR OFFiCI ----- <br /> USE No. ...---•-•-• <br /> ------------- AF.,, ,CATION FOR SANITATION PERMw. .. <br /> ------- <br />- ------------ ---- ---- - [Complete to Duplicate) - Date Issued ._.._./.�-•-� <br /> -------------- <br /> This permit Expires 1 Year From Date Issued <br /> permit to construct and install the work herein described <br /> Application is hereby made to the San Joaquin Locmy Ordinance No. 549.h District for a p f c (t.t"e- ._&'�y1 `� �4'r'�� "~Y <br /> This application is made in cornplian twiih County t 1Zatic __..._ . __...... <br /> ._. ... <br /> _f.12 - �_._.. --- ------- <br /> JOB ADDRESS AND LOCATION__:. ------------------ <br /> Phone.�? <br /> ��- _... -------------- <br /> Owner's Name----- ---------••-- <br /> ..... ._•... <br /> ----•--•---•-- <br /> (,t�-•`.`.`CM-•------• Phone-11-d_-- <br /> Address-•-----•----•------------- - -eh� �.t<_._ --•---• -.. <br /> .._. - <br /> SZz...:-- -- Motel ❑ Other 0 <br /> Contractors Name__-• �`Co ercial ❑ Trailer Court ❑ <br /> A artment House ❑ .._ <br /> 'Installation will serve: Residence C4] p <br /> Number of bedrooms ._`_ Number of baths ---J.__ Lot size .____._._ ------;- <br /> Number of living units: ._.__. ,•Qe pth to Water Table 2t)- ft. <br /> Community system ❑ Private ❑ p Adobe❑ Hardpan ❑ <br /> Water Supply: Public system ❑ ❑ Sand Loam ©-"Clay Loam ❑ Clay❑ r <br /> Gravel Y <br /> Character of soil to a depth of 3 feet: Sand „_ _ � —�❑ o ❑ FHA/VA: Yes ❑; <br /> y-'-r_- . .�- '�►r New--Construction: <br /> Yes <br /> - 1 No ❑ <br /> Previous Appl+�afion Made`•�11f Yesate--------- ----- " <br /> TYPE OF INSTALLATION AND SPECIFICATIONS:blic sewer is a vailable-within 200 feet.) <br /> (No septic tank or cesspool permitted if p j <br /> pistan a fro foundation--- M� of{aL.__i�r�---'ac � <br /> Septic Tank: Distance from nearest well---/.- r� --Li Liquid depth__._.. -------- p ty•'" <br /> No. of compartments_.__.__ <br /> -dG. Size__ �`------ 9 i <br /> each line___..S------ -------Width of trench------- $--• <br /> Field: Distance from nearest -----Distance from foundation.......��}__.__--•Distance to nearest lot tne.___a.._.••-.--- <br /> Disposal ,� <br /> ir <br /> Number of lines__.-------�--• Length o <br /> I � v-1ti <br /> Total length-------•------•---•- -•------------•---- <br /> Oc-}�-__-___.pepth of filter materlaL____:I_ -------•--- <br /> ��Q Type of filter material.__. <br /> �. _ . - Distance from foundation-------------------Dis+ante #o nearest lot ine_.•----•--•----•- <br /> Seepage Pit: Distance to nearest well_.__._-- --- - <br /> --..Linin material.--•-------------------Size: Diameter__._.....---•--•-------.Depth <br /> __.-•--••-•---•-------•-----._... <br /> { ❑ Number of pits------------------ g <br /> -------•-De th------------------•------------------------ - Liquid Capacity.. <br /> gals. <br /> l Cesspool: Distance from nearest well--------------•--Distance from foundation_-_.____-____.__.__.Lin{ng matena__.--.------•----------•- <br /> It <br /> 4 ❑ Size: Diameter------------------------- p --- <br /> Distance from nearest building------------------------------------- <br /> ------------ <br /> Privy: Distance from nearest <br /> well------------------------- Ci <br /> -------------•--•--•-- <br /> Distance to nearest lot line-------------------------------------------------------------------------------------- <br /> ` <br /> ------�`-`•-----••-•-�•--�-L3�'��.---� __.__��`-� - A��rp-a--q-1-�--`�``.i.�c.-�! <br /> _.� . �. <br /> ❑ <br /> AnL --------------------------- <br /> - <br /> r ` ----•---• <br /> e <br /> _Remodelin and/or repairing (descrbe):------- ••------ ---------------- ------ --------- - •------•--------•----- <br /> }-• - --------•------•--•-------•--••- <br /> 1 <br /> ----------------- -- <br /> -------------------- <br /> if that I have prepared this application and that the walkHeawill <br /> l heDistrict. accordance with San Joaquin County <br /> 1 hereby certify <br /> `rl ordinances, State laws, and rules and regulations of the San JoaquinOwner and/or Can#tactor) <br /> (Title) i-` '- - <br /> _�- S, ..:. � �� ------------------------------------ ----­-----_ , <br /> f <br /> 4 Plot ellen, showing size lot, location of system in relation to wells, buildings, etc., can be placed on reverse side]. ' <br /> ( r , <br /> FOR DEPARTMENT USE ONLY <br /> / ?--•--------•--------- <br /> -------------------•-------•------.. DATE----�--.�-_ -_.`_<? <br /> '---------------------- -------- <br /> R <br /> - -- <br /> -- •----- DATE------------------•..-----•-"-----•-••--•---------•- - <br /> APPLICATION ACCEPTED BY------------1­I-1_-\1- -------------- -- • <br /> ­---�--------------------------------- <br /> E BY--------••--------- --•-- ------------------------------------------ <br /> BUILDING <br /> •-------•---------------•- <br /> BUILDING PERMIT ISSUED_...__.---------------- <br /> --------------- ---------------------------------- <br /> Alterations and or.recommendations:"----------------- ----- <br /> ------------•--------------------•------ <br /> l --... <br /> ••--•--•--=-•-•----•--- --•-------"----------••----------------•--------••---- -------------------------------------------------------- <br /> 1 --•........ .........:... <br /> € y --------------• --------------- <br /> ------------------------------------ ------------------- - .............------------------------------------- <br /> -------- � / s <br /> Date ... � . .. ................................. <br /> FINAL iNSPECTI Y..- -``�--- ----- --- -------- <br /> SAN <br /> "-- ---SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 144 sycamore Street• 405 West 9th Street <br /> 130 South American Street <br /> t 300 West Oak STTeei Tracy,California <br /> I � <br /> Stockton,California <br /> Lodi,Callfomla Manteca,California <br /> ER 9 REVISED 8-89 ZM 5-61 ATLAS - - - - <br />