14866 - Laserfiche WebLink

Home Browse Search

FOR OF Fal/C,E�E: ' f� � 71 OPermit No. APPLICATION FOR SANITATION PERMIT 1 ...._.__ ...... ------------ ----------- ----------- ------- --- --- (Complete in Duplicate) �U/ 7✓ _ ..�.- This Permit Expires 1 Year From Date Issued Date Issued __........ 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. _-_.,- -- r . ...•_.,.. ,,,,,. �. JOB ADDRESS AND LOCATION - - - --- --------7^4,,1,0; � --- ---- '2-k'- ---•.t• ••"�== Owner's Name------ -----• ------------------------------------------------ Phone------------------------------------ .................................................... Address......................... ..-...- • ••-• ---- •••••--- -------•............................... Contractor's Name. ---`�--T--------•-••------_ ------------------------------------------------------------ ---- Phone Installation will serve: Residence ❑ Apartment House ❑ Commercial Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ........ Number of bedrooms,___-___. Number of baths ,j____ Lot size __„ Qp . ................................... Water Supply: Public system Community system ❑ Private ❑ Depth To Water Table AP.— ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ S ndy Loam E] Clay Loam C] Clay ❑ Adobe EEr'-H—erdpan C]Previous Application Made: (If yes,date--------------_----) No New Construction: Yes [�r_No ❑ FHA/VA: Yes ❑ No 2�-- TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) � r � Septic Tank: Distance from nearest well__%FP__ ---- Distance from foundation_1...__________.Material-___� [V No. of compartments---------l-...... .....Size------ Liquid depth.... -------------------Capacity----- �� Disposal Field: Distance from nearest well_ q_----__Distance from foundation_.