16409 - Laserfiche WebLink

Home Browse Search

_ __..-yrs FOR OFFICE USE: --- ------ ------ --- -- Permit No. ------ ---------------- k. �APPLICATIONIFOR SANITATION PERMIT ---- --- ------ 4 r � q �j ----- ----------- Date Issued ,,,,,,t -------------- -------- (Complete in DuplicafB) _ - , � _. This Kermit Expires 1 Year From Date issued lication is hereby mada;to.the San Joaquin ocal Health District four a permit to construct and install the work herein described. Thisapplicationis made in compliance with County Ordinance No. 54 -------------------------------- JOB ADDRESS AND LOCAT ON j=l Phone-. Owner's Name---------- '" ------ - --------------- Address-----•------------------ 1.1,-----------•- 76 - ,i �r Contractor's Name_-______.-- -_ € F Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Installation will serve: Reside n e J& pa�tment Houss ❑ ---------- - Number of living units: tl-___ Number of bedrooms _"'lumber of baths _'7 Lot size --.---- .: : ► E Water Suply:. Public system � Community system El Private E] Depth tft. o Water Table _. � j pP y: Character of soil to a depth 'of 3 fes#: Sand ❑ Gravel ❑ Sandy Loam F❑ Clay Loam�' Clay ❑ Adobe❑ Hardpan [] x I FHA/VA: Yes ❑ No [9 Previous Application Made: (if yes,date--------------- ---1 No 5( New Construction: Yes ®� No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: [No septic tank or cesspool permitted if public sewer is available within 200 feet.)' Material____.�- �� i Septic Tank: Distance from"nearest well--.----- "" Distance from�foundation-___�l------- -Ca No. of compartm1115 ent : Size_.,�_ AW' :: �Gui e p. 14 1 p Y-- Disposal Field: Distance from nearest well_.__ ----Distance"from foundation__.__ ---__Distance lot line------- Dispo'al Number of lines___. -- Length of each line____- _____ A" AP---Total length. Type of filter material____ Depth of filter material__-,��--- er--�-- Seepage Pit: Distance to nearest well---- "w Distance f m foundat.ion____ -_4__ •_Distance to nearest lot line__---f.-y-- � 4 t .__Size: Diameter- r -�•-------.Depth-- : • --------------------- lumber '"-f------------- Number of pits:._--__ - Lining .material-_ Lining material Cesspool Distance from nearest welL_.__- -DDe fh_— from foundation---------------`___Liquid C pac-ity---------------.-_____.---ga4s. Size: Diameter_'-.. ----------------------------- E1 p _ r• ' 4-- -'-""'" " -,--Distance from m nearest building--___ Distance from nearest well __ ---- - - Privy: ------------ ----- ----- ----------------------------------------------- Distance to nearest lot line..._------------------ -- � t a. Remodeling and/or repairing (describe):------- ---------------------------------------- - - - e . ;� ------------------------------ --------- --------------------- = I --------- - -----------------------------------=----------- --- ------- --------------------------------------------------- ---------- -------------------- I hereby certify that I have prepared this application and that the work will be done.in accordance with San Joaquin County ordinances, State s, a rules and re ' tions the San Joa. uin Local Health District. t �--------------------_.[Owner and/or Contractor) - - = (Signed) ; --------------- - e- By------------------- ., [Plot plan; showing size of lot, location of system in relation,to s e1ls,,`buildings, etc.,; an I;e placed on reverse side). _ _r ti FOR D RTMENT USE ONLY . �-rDATE------ -------------------- APPLICATION --------- ---- -- APPLICATION ACCEPTED BY____ -------------------------- , 1�.�-..,, = -------�^� DATE_- REVIEWEDBY------------------------ ------------------ -------------------- DATE:-- ----- --- ------------------------------------------ ----- ------------------------------ •-- BUILDING PERMIT ISSUED------_-- -- µ ---- Alterations nd o recommendati s:.__-f - pyt/ _ ------ --------•--- -- ' � - - ----- -- /�- - ' fs� ---- ----- -------- --------- -------------------------------- ----------- Date ----- ----- _ ,mac_. ----- ---�ir�-rte -�' Y_ - --- ------- ate... ----------------- - - ----------------------------------- FINAL ------ ----------------- - --------------- FINAL INSPECTION BY------------------------------------ ` --------- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Ha:elTon Ave. 300 West Oak Street 124 Sycamore Street 205 west 9th Street •�-STocklon,California Lodi,California Manteca,California Tracy,California ES 9 R)EVIS EO B-59 3M 3-'63 r.R.co. <��