20153 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: - Permit No. APPLICATION FOR -NITATION PERMIT --------------------------------------- (Complete in Duplicate) Date Issued This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install a work herein described. This application is made in compliance with County Ordinance No..549. / --•--- - Owner' JOB ADDRESS AND LOCATION--.'. ------- -f-- ---- -- -- ---- ------------- Phone .--------- r Addresslx---f.:... `'"'..`-- ---- ---- - ----------- l_ Contracto'r's Name - .... ... ..�------ fi-------•:_- Phor'- �- K - ` 4 --- ' r. partment House ❑ Commercial ❑ Trailer Court ❑ Motels Other Installationwill•serve - Residence. M'� Lot size _ > - ` --- Number of living unit--- Number ofbedrooms"_ Number of r 1. Public s stem s �mmu it i system ❑ Private i epth3to Water Table _.___.. ft. Water Supply: y .D Tom, 1 Character of soil to=a`depth of 3 #e�'t: an Gravel ❑ Sandy Loam ❑ Clay Loam ❑ 0ay ❑ �dobey Hardpan ❑ s date...._.- ---: No 17-1 'New Construction: Yes ❑ No FHA/VA: Yes ❑ No ❑ Previous Application Made. (If ye r, , TYPE OF INSTALLATION ANPSPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available witfiin;200 feet.) I S Ic T nk: istan'e}fro•mp nearest well-----------------Di is ante from foundation__.__----..--_---__Material-----..-___._.---.__.._.__.__------------------. h _ Liquid depth--------------- -----------Capacity No. of tom;partments---------- ---------- Size_�*.---------•---------- -_,_ --------------- ------- I p n Barest well.................Distance from foundation_____ - ---_---Distance. to nearest lot line._-------------_. s osal eld: Numbee of lines':-.-- ------Length of each line------ r- "'- -------Width of french---------------------.-------------- I f # r -- , -Total length--------------------------------------- are # well.-if_ �-------_Dispant from'Noundation Type of filter material------------------------ _Depth of filter mate 0 Di n to nearest lot Se ge Distance to ne l - -----.Linin material_-ct.C.� _.Size: Diameter_ _-- --- �f_.Depth..v . Number of pits--- ---- ---- g � J ZCess oo �, Distance from ,nearest well----------------Distance fro oundation___..____...__._-- Lining material_..___._....____..___..._._______-. ❑ Size: Diameter'-------------------- -------- -------Depth------- ------------------ ---------------------- Liquid Capacity----- ----------------- -gals. t Distance from nearest well---------------_---__.___.____----------- Distance from nearest la ilding._. ___.. ------ } Privy: Distance to nearest lot line._..__________________ _ ---------------------------'h 1 - -- ----------- ' Remodeling and/or repairing (describe):----- �.� ,� ��------- .0 ' --------------- ' r-- - ---- --_--------_ --------- ------------------------------------ '.-------•-- �--------------------- s -- ---- ---- - w� PP . - -- ---- done II hereby certifythat I have ,re d�th ons of the San Joaquin the HealtheDistr District. accordance with San Joaquin County •E . . - p p ordinances, :State laws, and rules and reg ` a.'"a `" r Contractor) .............. ----- (Siged) n 3 By:- ---------- -------------------------=-------------------- a (Title---------- --------- - --------- - ---- (Plot plan, showing size 6f lot.,locItion o system in relation t ells, buil Ings, C. canobe placed on reverse side). r FOR DEPARTMENT USE,ONLY D_�TE�. ,✓_ -------------------------- APPLICATION ACCEPTED BY---- I � �. ---�----- ------------ �--- DATE-----.-------- - -------------- ------•-----=-----------.. F ----- REVIEWED BY , �-------- ------------• DATE- -------------- - ----------------------------------- BUILDING PERMIT ISSUED-----------' ��•-------- II Alterations and/or recommendations:__.------- -------,f- G - K----- I ------------ ----- --- -- - -------- 1 ---------•------- --------------------- ------------ ------ ----- ------ ------- ------- ------- ------------ ---- ------------------ ------ - 1 - ---------- - - - ----------------- ----------------- - . . FINAL INSPECTION BY-------------- ------------fNJOAQUIN LOCAL-HEALTH DISTRICT 1601 E.Ha=anon Ave. . 30 Street 124 Sycamore Street 205 West 9th Street Lodi,California Manteca,California Tracy,California Stockton,California F.P.C C. /