12101 - Laserfiche WebLink

Home Browse Search

�OA'y �~ APPLICATION FOR SANITATION PERMIT Permit No. ../ - /�n^ �: (Complete in Duplicate) Do+n Issued ---- Application This Permit Expires I Year From Date Issued Anp|icmtion is hereby made to the Son Joaquin Local Hnu|f6 District for u permit to construct and |nstoU the work herein 600c,i6e6. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND " ------------------------------------------------- ------------- ----------------------_.-- ownerm ------------------------------ ---------------------- Phone ---------------- _---- - Installation will serve: Residence 155�parfment House F Ile ] Comm rcial Trailer Court Motel 0 Other �� Number of |��g units:n� �-- Number ofbedrooms /,' N-�--, of baths/ '' Lot size '-'mcd�� '--''_-- Wafe, Supply: Public ,yo+om �ommun|+y system [] private F]. Depth to Water Table hrft ' Character of soil to u depth of 3 feet- ` Sand Gravel Sandy Loom F-1 Clay Loam [] Cloy 0 Adobe"rd' n [] Previous Application Made: Yea [] No �^~-~NewConstruction: Ye-s E] NoJ2-~ FHA/VA. Yes E] Nu'@Er� } TYPE OF INSTALLATION AND SPECIFICATIONS: ^ (Nm septic tank or cesspool por�nYtfo6 if public sewer isavailable within 200 feet.) Septic Tank: Distance from nearest well-----------------Distance from foundation--------------------Material -------..--------- -,---- �] No. of compartments----------- ------- -Size_.-_------^..UqO[d 6eA!h----------- --------------Capacity----------------- Disposa) Field: Distance from neum,+ well----------------- from foundation----.-_'Distanco to nearest lot line'----^-- Snep Pit: Distance to nearest woK14- �M to nearest lot |ine_'47�!'— Num6orofpit,--/----Un|ng m Diom°+o,.��.��--Doot --��.^--_-'- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material --------,_-- �r ` [J Size: Diameter--------------------------------------Dept -------------------------- ------------------------- Capacity----------------------------gals, ' Privy- Distance from nearest well''--''--''--''-'''--Distance from nearest bui�Jing.'----'--'-_--'-�' [] ' Distance to nou,e,f lot line.----- ------------------------ -------- -------------- Remodeling and/or ,upo�ring (describe):--------------------------------------------------- -------------- -------------------------------------------------------------------------------------- ._._--.---_---.---.----------.-------'_----------_--.-----------_---------------- ` ' —''-'-'--'---'-�'----'---'-'-'--''-_--'-_.''---'__.__----_.''-_-_-_.-----�--.--''-''-''''-''-' . -------_-------_-__.__-__.-^-'_..___------_-__-__.--�-_'------_—.__------.---- � 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 a do regulations of the San Joaquin Local Health District. (Plot plan, showing size of lot, location of system in relation to wells, buildings, efc., can be placed on reverse side). --le 1,_9F9A DEP��TMENT USE ONLY ------ BUILDING PERMIT |S6UED.-_-------'&��__--�--'--.__-_-._----.----. TE ----------- Alterations and/or ---.,---_______.________.______.__________________ ------------------------------------- -------- __ ___ __��_��_�___��_��_�__��____��'_��'_� --0��..x��-_---_-_--.--_-_._-_---.________.__. - -------_---__- ---------------------------- ---------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------- ---------- --- -------------------------------- ------- -------------------------------------------------------------------- ��---_�_�--__------__---__-----_---------_-------_---------_---_---------- ::]�, RN/4L INSPECTION BY -'--- Date-- �x�' ------------------------------------ 'SAN '-''--'---'--' ��NJO��U|NLOC�LHG�LTHDBTR�T /»o South American Street 300 West Oak Street mx sv"°m"= str°°v o/w worth "C" Street Stockton, California Lodi. California Manteca, California Tracy, California o-9-2m m°'"ao"," rzc°.