74-14 - Laserfiche WebLink

Home Browse Search

a,)-Ot F it SANITATION PERMIT T FOR OFFICE USE: �APpL1CATl N� X j � Permit No. ...-�T.-�.T.•- "... .. ......... ....................••--- (Complete in Triplicate) f :......................... Date Issued This Permit Expires 1 Year From Date Issued � C� Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein d 'escred. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: �f ...... ........... .-... fey_ � AX ��:��...�!�.-CENSU5 TRACT ... � JOB ADDRESS/LO� ION ......._....._....-. - / Phone ............ Owner's Name .... 1 .... ......�.r� � _...._-... city ....��' ,� . Address W....93._ ....�4r..�.... 1 # Phone....License Contractor's Name � •-�-- E Installation will serve: Residence partment House 0 Commerclal []Trailer Court i[] Motel.[:]Other ------...................................... _, --- s .. Number of living units:.._-JNumber of-.bedrooms ��........Garbage Grinder 1--•• Lot Size •.- ...... �� Private �- ------••----.....•. ----------------- ------------- Water Supply: Public System and name ----------------------- --------------------- , Character of soil to a depth of 3 feet: Sand[]:Silt❑ Clay Peat❑ Sandy Loam Clay Loam j] 4 Hardpan ❑ Adobe M, Fill Materia ....-.....__ Y type - -- �� if es, a -------------•-------- • - t. . (Plot pian, showing size of lot, location of. system rin relation-torw.elis, buildings, etc. must be placed on reverse side.)}� NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available. within 200-feet') Liquid De th ..' ;��._ ...... iae...._ P PACKAGE TREATMENT [ ] SEPTIC TANK d -X � Type` �__L _Material--- �!e! _. No. Compartments �_-...:., ......1 Capacity ) Distance to nearest: Well ..._' --'.....................Foundation . U- ----• ----- Prop. Line .��: - ----........ t Length of ch Iine-F �J__. ,5. Total Length _ LEACHING LINT: [ Na.l'of;Lines - . ,_.,-__ D' Boxi , Type Filter Material ..-Depth Filter-Material _.� :.--•--•••- --•- v , • r' Pro er Line s;5 ................ pistante,to nearest; Well ._,�.��......---. Foundation P_ tY ,_ _ �.,.r... t Rock Filled Yes 3 Depth -,Diameter .1- .i _-Number _: _.........:. SEEPAGE P17 [;�—P - J'- • y Water Table Depth 6 ..f:..... .................Rock Site ...�,1�': _.---•-•- �: Distance to nearest: Well ..--.,1? - .....................Foundation ----- -•Y••.---• Prop. Lin .... . y REPAIR/ADDITION(Prev. Sanitation Permit# ......................... •---- Date ............ ••••------ ---- ---- - Septic Tank (Specify Requirements) ------.. ... u - Disposal Field (Specify Requirements) . -------------- ----•------ ------------....-•---------------------- -------------------- (Draw existing and required addition on reverse side) I hereby certify that I have prepared this application and that the work will be done in accordance wish San .iaaquin i. County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or licen- sed agents signature certifies the following: ( "I certify that in the performance of the work for which this permit is issued, I shall not employ any person In such manner as to become subject to Workman's Compensation laws of California." l Signed -------------- ` Owner u .............••---• -- ..--------.-._.... ... _�. �iNe �-' By --- -••---.. � .•.. - ...... " � (if of than owner) FOR DEPARTMENT ,USE ONLY APPLICATION ACCEPTED BY .....__ G...._._....• --•-_. DATE _..l .�.. - : .. •------•-- BUILDING PERMIT ISSUED .................................. ..........f.:... ... ............................--- DATE ............................ ADDITIONALCOMMENTS ......---••---.....................................•-•-...-....----...............-----......._.....--- .... ------•.-. ....- ------ .................................. r...................._..... ._...-..._.' '.... -y.,.]-•................. Final Inspection by: _. - .........---'Date . � ...1.-....... r SAN JOAQUIN LOCAL HEALTH DISTRICT 7/723H 7L"