Laserfiche WebLink
rAjKurt-K-t U5t, <br /> --------•-- <br /> --------­- ------- <br /> L APPLICATION'FOR7"SANITATION PERMIT Permit No./ <br /> a <br /> ................. --- ------- <br /> -1...­­­­----­'.� ? ;Complete in Duplicate) <br /> ......­­........... <br /> Tris Permit Expires I Year From Date Issued Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and instmil the work herein <br /> This application is made in coMpliance wiA CgVPrVV-;hance No. 549. described. <br /> JOB ADDRESS AND LOCATION-of <br /> -x <br /> Owner's Name-­-� <br /> .....40 <br /> Address -Ir--- ----- ----------- --------------------------- ---------------------------- <br /> --------- --- Phone---........ --------------- <br /> ;eCa�....­ - 0-- ­ ----­-­---- ----------- ------------------------ -----------------------------------........... <br /> Contractor's Name..___-_-• -------------- <br /> -/i*­Pr0_.../rVrr,-791 -------------­--­­--------------......­-­----- -----­--------­ Phorie­­................ <br /> Installation will servo: Residence g?"lAparfmant House 0 Commercial E] Trailer Court [] Motel E] Other E] --------- <br /> Number of living units. Number of bedrooms S- Number of bathsv-4. Lot size -aW-a <br /> - <br /> Water Supply. Public system Community system C] Private 210'15epth to Water Table/qrff"0 ....... <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam Al-o5ay Loa <br /> F yes,date - m El Clay L1 Adobe 0 Hardpan <br /> Previous Application Made: I <br /> --------:...... No -"New Construction. Yes a . <br /> FHA/VA. Yes-W-- No El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS- <br /> (NO septic-tank Or cesspool permitted if public sewer is avail-able within 200 feet.) <br /> Sepfic Tank: Distance from nearest well Distance <br /> No- of compartmeln'15.,- <br /> J�rrn gf.�,,,und0tion-o7-47,.......Mataria!-&e-,JO-� <br /> -- -------- depth--__'y----------------capecity�� <br /> Disposal Field-. Distance from nearest .._.Disfancafrom foundation- to nearest lot line---47-7'.­ <br /> Number of lines- f-.7. --- Length of each line-- - ---- <br /> 4 aterial------- 0-- Total length- 4-,A0 <br /> Width of frenrh <br /> Type of filter maief;Z��- -J�4 _-Depth of filter material.... <br /> Seepage Pit: Di5iance to nearest well------ ----- ---------------- <br /> --------- from foundation............... to nearest [of line­ <br /> F] Number of pits-_ .!�---------- ----Lining material------------------------- Diameter-------------------- Depth__....___--- <br /> ,1 ---- <br /> Cesspool Distance from nearest well-----------------Distance from foundation--...--------- .--Lining material-,------ ------------- J.I <br /> D Size:11*Diamofer.......---- --------------------- -Dept h------------- ----------------------- - ­------------ <br /> Privy: Distances nearest well--, % ---------Liquid Capacify-------------------------- <br /> ........../-­­-Dislance from nearest building,........ <br /> ❑ Distance G—nealrf;H; lot line--•-___--- ------ -- ----------------------- <br /> -------------------- ----------- ------ ..................... ---- <br /> - ---------------------- - <br /> Remodeling <br /> ----------- .........--------------- ------ ---------- <br /> -------­--------±:-!!'�------- ...... ..... ------- <br /> -------- ...... ------------­­......------ <br /> --------------- ------ <br /> --------------------- ------------ <br /> ------------- --------------------­------------ ------------- ------------ ......---------------------------------- ---------------------- <br /> ----------------------------------------------- d ------ <br /> -------------------------------------I----­------------------------------- <br /> ------------------- ---------- <br /> is OPP icafii��And <br /> red this 'friffKe work will be done in accordance with San Joaquin County <br /> I • <br /> hereby certify that I have prep�" -------­......... <br /> ordinances. State laws, and rules and iregul&'iOns Of the San Joaquin1ocal Health District. <br /> --- -------- <br /> ------- <br /> (Signed) - <br /> ................ <br /> ------- ------­ t94="v=cZVPr Co <br /> By <br /> ntractor) <br /> ----------------- -- ......... ----------------- <br /> (Plot plan, showing size of lot, location a4 system in tion to wells, buildings, efc., can be placed an reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATIONACCEPT�E-D BY..... � AL <br /> �r ----- ---------------I——-------- ----------....... 6A <br /> REVIEWED BY <br /> -------------- <br /> --­------------- ----------­.... DATE- <br /> --------- --- ...... <br /> BUILDING PERMIT ISSUED <br /> '-"- - - <br /> --------- -------------- --------- ------ --------------------- ---------------- DATE------------- <br /> Alferatiani and/or recommendaf ions: <br /> --------------------­­...... <br /> ---------- <br /> --------------------------- ...I........------- •.. ...................... <br /> -------------­........I------I-------------­----------------- ------------------- --------- <br /> ­I------------------------------------------ ------­­­­­------ <br /> --------------------- --------­ ........---- ---------­.­........--1----------------------------------- -------- ---11-------- -------- <br /> -------------------------- .......­­-------- -------- -----------I---------------­------------------ <br /> .................------ -­­ ---- --- ------------- <br /> ---------••••••--------------­ <br /> ..........--------------------------------- <br /> ---------- <br /> ------- <br /> FINAL INSPECTION BY:.-/ Date.--.A <br /> ------- -------­­------ ----- <br /> 1601 S.N;tzelton Ave. SAN JOAQUIN.LOCAL HEALTH L, DISTRICT <br /> 300 Wet*Oak SirGef 124 Sycamore Street <br /> y. Li <br /> Stacicton,California manike,California 205 Well 9th Street <br /> Lodi,California <br /> Trary,California <br /> FLP.CCJ. <br />