Laserfiche WebLink
- <br /> � <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) Date Issued <br /> _~f' <br /> . . <br /> App||cution is hereby made fothe San Joaquin Local Health District for apermit +oconstruct on6indaUthowor herein described. <br /> This application is made in compliance with County Ordinance <br /> JOB ADDRESS AUP LOCATION Pp'A4UM -_ - <br /> 61 ff ...... I- -----//--A944w,AU11eW40_�_ -- <br /> Installation will serve: Residence Apartment House 0 Commercial I-] TrItler Court [] Motel 0 Other 0 <br /> Number of living units: --I corns ---- Number of baths <br /> Water Supply: Public system El &mmunity system C] Private Depth to Water TableX-jO- ft. <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam 0 Clay Loam Clay El Adobe [I Hardpan El <br /> New Construction: Yes 1�2 No G—PHA/VA: Yes 0 No El <br /> Previous Application Made: Yes El No 5X OM <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or'cesspool pe'rmitfed if public sewer is available within 1 200 feet.) <br /> Disposal Field: Distance from nearest well- In------'Disfance from founclation-:6-9-----------Distance to nearest lot line__1_971_+. <br /> Seepage Pit: Distance to nearest well-----14;0_��---Distance from f clation-1.17---------Distance to nearest lot line_J_r_+___ <br /> A % <br /> D|��nce to nnnn,ut |o+ |ine.�--.-_--_--���--'__.--_-_____--__________--__ T <br /> �'/�uRamo6�ing ond/or re9urmg �do�chb�)�-----.--_-.---_:-__.___..__-__--_-_--_-----_-._----__._________._________ ^ _. _______________.__.___.____________________.______________ <br /> --.'-'---_'--'-''-__- / ''------__---'-___'--.-''-'''__-__''-__--'-------'''--.-_-_-.''-'-'---'-' <br /> .--.___—__.-'_-_--/Z.___.._f-_------__-_.--_--__-__-__�__-_--._---___---_--._-_--- <br />� I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ---_-_- Sto <br /> laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Signed)-- <br /> (Plot plan, showing 'size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> �-���� <br /> APPLICATION ACCEPTED 8Y-. -------------------------- ----------------------------- OATE°r-���.�m.^c_---.---_.----. <br /> DATEREVIEWED BY---------------------------------------- ----'' --------'--------'--'-- <br /> BUILDINGPERMIT ISSUED-------------------------------------------------------------- -------------------------------------- OATE----.-_--------------' <br /> Alto,mtiops and/or ,ocqmnmwndmfions:------------------------------------------------------------------------------------------------------------------------------- ------------------------------- <br /> -----------------------------------------------------------------------------------------------------_--.-----_-__--'_---.--.___.-_--_-_.__-_- <br /> ------_------------ __---------------_------'���__---__-----_--__---_��� --___----____���______-----___--------__------'___-----____-----__----------------_--------- <br /> ---_—__-_--._-_-_------__---_--_-_-.__--.-_--.------_._--.---_---_' <br /> _ __ _ _ _ ____________________�___________________'______________ <br />. ------------------------------ '' ������� <br /> FINAL INSPECTION BY:_- /\. '�/ �-_'' Do��-'''�������K�����. ---------------------------------- <br /> SAN <br /> ----'--_'--' <br /> � SAM JOAQU|N LOCAL HEALTH DISTRICT <br /> /30 South American Street 300 West Oakstree4 /32 Sycamore Street 814 North "C" Street <br /> s*o=kt"". California Lodi, California Manteca, California n""» California <br />