15144 - Laserfiche WebLink

Home Browse Search

FOR OFFICE U E; �. = - - 0 A&CATION. FOR SANITATION PERMIT Permit No. .................. -------------------------- (Complete in Duplicate) 'z— _____ This Permit Expires 1 Year From-Date Issued Date Issued _--6 --------------------------- + Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. o f U),Y/f igy JOB ADDRESS AND LOCATION_,_ -------------- _ -'-_-'-"_." Owner's Name...... tip. _ �'f_s GTS-- /� ��r�----------------------------------------- --------- -------------------- Phone ...710,5;;'.�r_--- Address----••------. IYyl ...... .. E?1tG .1._..�X_ ! �S'er`' ----------------------------------- ---------------------------------------------------------------------- s.. / [~� �} fes, / 44/ Contractor's Name-.l-f7. ` 1+C� _rJ:P¢ t 01.12 - NYS+ Phone 2T 1.1 1�. 7`y.... 1 + Installation will server Residence;K Apartment House❑ Commercial ❑ Trailer Court ❑ Motel [3 Other [3i Number of living units: _�__-. Number of bedrooms ;_. Number of 1 aths _/___ Lot size -----,l-[.fes P,...-..-- ---•-.-.•------- Water Supply: Public system ❑ Community system [I Private �epth -ro Water Table _,460 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel E] Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe 23--"Hardpan ❑ Previous Application Made: (If yes,date--------------------) No or New Construction: Yes ]IQ INo ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION"AND SPECIFICATIONS: i (No septic tank or cesspool permitted if public sewer is available within 200 feet.) ' Septic Tank: Distance frompnearest weIIE�_�__- __Dis#ante from fgun atih}n__ _�____--.Material_______________ ___________ +s No. of compartments___----------------Size `!.X--6�-1 Liquid depth_.. `____------Capacity..-------��7+4.1,i r � Disposal Field: Distance from nearest well_�L9_______Distance from foundation...- ....____Distance to nearest lot ,cANumber of lines___________ _____________ _ ____Length of each line__f1�'._.._`-_.____-_---.Width of trench_____.._ __'� ---.----•-------. Type of filter material i _ De th of filter material___,� ��__--___._Total length____ Q- -.•------------------- ._. �- C--- p O Seeps e.Pit: Distance to nearest well--- - Distance from"foundation c _�..r__.-.Distance to ne rest lot line___ ©_ Number of pits-----I-------------Lining material._Pad)------::.Size: Diameter__ !----------Depfh__taZ.�' ----------------- Cesspool- Distance from nearest well----------------- from foundation- ----------------.Lining material..-.-__.._..__-____________-...------ U (] Size: Diameter. , als. --------------------- Depth r Privy:. Distance from -. .. ~_ t nearest well-_________________ __________�'_..__-_--------Distance from nearest"building_____.._______________......__.__._-___._. i ❑ Distance to nearest lot line---------------------------------------------- -------_-----•- ----------•--=-----------• -------------------------- Remodelingand/or repairing (describe):------------------------------------- --------------------_-----------------------------•-----._-..-•-----------•-•--•-----------•-------- j i ___________________________________________________________----_--------------------------------------------------------------------------------------------------------------' i ____________________________________________ _ _------------------------11----------------------------------------------- ------------------------------------------------------I—----------------- _ _ ____________.-_._____--.-_____________-_.____________________.__.________-._-_______.__-__._______-_____-________.___....-._____----_____.__ hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State I ws, and rules and regulations of the San Joaquin cal Health District. �j --tContractor)- ----- (Signed)--- -- - -- -- ---- +- �' U -- - -- ---------(Title)---------------------------------- (Plot plan, showing size of lot, location of system in relation to Is, buildings, c., can be placed on reverse side). t FOR DEPARTMENT USE ONLY [ n---- � -------•-__-------------------- DATE-- r:.. �� Z'----------- APPLICATION ACCEPTED BY_.__�. -- ---.-----�-�------------------------------ REVIEWED BY------ 1 DATE . ---•--------------- BUILDING PERMIT ISSUED__ 1 DINE_______________ AFFeratio�+s an /or re ornm dations:_ --- ------ '`"�' 'G � --�=�-j ix -------------------------------------- --------------------------------------------------------................ ---------------- -------------------------------------------------------------------------------------------------- ---------------------- --------------- I ...... -------------- --------------------------------------------------------------------- ------------••--- --------------------------- --------- ........ ------------------------------------------------------------ -------------------------------- ..... ------ ------------------------------------------------------•-•---__. •------- _ ,d FINAL INSPECTION BY:.- f Date ` y SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 1424 Sycamore Street 205 West 9th Street Stockton,California Lod{,California Manteca,California Tracy,California ES 9 REVISED 6-59 2M 5-62 ATLAS _