Laserfiche WebLink
APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in <br /> V Duplicate) Date |omxy6 ' <br /> /" . � ' -- to -- --n - <br /> . � _ <br /> Ownerapplication is made in compliance with County Ordinance No. -549. <br /> JOB ADDRESS AN� LOCATI N.XT-3./ <br /> _ . Name----~°---. - <br /> ------------0. <br /> Contractor's Name— <br /> Installation will serve: Residence 9��parfmenf House E] Commercial [] Trailer Court El Motel E] Other E] <br /> Number of living units: -/--- Number of bedrooms /--Number of baths J,--- Lot size -4-6f----X/ A­::� <br /> Wafer Supply: Public system 4-Gommunify system E] Private [] Depth to Wafer Table 413 ft. <br /> Character of soil to a depth of 3 feet: Sand 0 Gravel E]' Sandy Loam Ej Clay Loam E) Clay E] Adobe 6-44a-rd-pan E] <br /> Previous Application Made: Yes E] No Cl`qew Construction: Yes [-].No E4. <br /> TYPE Of INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted |fpublic sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest' -Distmnca from foundation-- <br /> 9-1 No. of compartments--------I�'----------6izv`1ar.X..(t/q--Liquid 6ep�k­��.. -------------- <br /> --a *-' <br /> Disposal Field: Dis+onoa from nearest <br /> »' | - Distance from foun6ufiun`-^2-----Distance to nearest "^ ||no-' ------ <br /> Number <br /> ''- <br /> ' <br /> u Numb� of lines + Lenothofeach |i ofh �� � <br /> �� � G|�rm*��|.�.�� ��'Ue� � fi|�rmo��L-�Y-��| length���� ' <br /> -------------- <br /> SeeH�' �i,�n� � n��� wr|���� D�� fRm <br /> , � ncnnceto nearest lot line--./ ' <br /> ��--- <br /> Number of pits-'^�-----.-Lining mate,i�i �So,� �io ' /+*r r��------ -------Depth'Zn:;?�-------------------- <br /> Cesspool: Distance from nearest well-----------------Di,tmnce.frnm foundation.. ------Lining muh:,iu| <br /> =- <br /> �-..� <br /> -. <br /> _-''.- -[ 3�e: D�mete,.-_---------..Depth-.=.`--''_-''-''--''-'L6lwi6'Capu�fv _- _p�vy: D�f nco from nomru� weU-'-'' ' gals. <br /> ordinances. S�4fe laws, and rules and regulations of the San Joaquin Local Health District. <br /> FOR DEPARTMENT USE ONLY <br /> -�--'--'--�-'Distance[] D�foncetonearest lot |inu_�- <br /> Remodeling and/of repairing (d�c�6e):---._-----_-'___-'----___ <br /> —'---------'---''''-''--''-------''---'-''----------'''---------''-''------''-' -' '�'�-� <br /> . <br /> --_---_----_.___-_-_------._-_----__--_...___..__--___-._---__--___-- ._ -' <br /> ---'--.-_'''''--'-'''-_.-_.''__'--_-'-__.''--.---_.''-_''-_.''-__--'_----- <br /> , <br /> hereby certify that I have prepared this application and that the work will be done in accordance with San <br /> '-'-'--''--''--� � -'--'''-'''''-'-'_''-- -'--'''''-''-' '__' - - . <br /> �NAL INSPECTION ---- �z -'� ��^ `------- "*n,-- - _ <br /> SAN JOAQU/N LOCAL HEALTH DISTRICT <br /> /oo South American Street xvuwemOak 5+�°+ /32 Sycamore ��* 814 North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> ss-9-2" ,^5°",,°""" ,"°, <br /> ~� <br />