22021 - Laserfiche WebLink

Metadata

Thumbnails

Annotations

FOR OFFICE USE: e �? -%6 2- r-rl9a 7 - - - ------------ -------- ----------- --------------- -------- - APPLICATION FOR -SANITATION PERMIT Permit No. - =--- -------- - -- ----------------- - ------- (Comple+e•in Duplicate) Date Issued -7--=& This Permit Expires 1 Year From Date Issued -6e 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. � 616 - 0 549 5 -------------------- ---JOB ADDRESS At4O LOCATION------- ----- J ' Phone - _ Owner's Name------ --- -. / ------------- Address--------- --------.... ----- 1 -------------------------•-----------------------------------------------------;-•--------- ---------•--------------.- Contractor's Name----------- ��G ------- Installation Phone------�-------------•-------• Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ M,ptel� Other F]Number of living units: _/r_ Number of bedrooms . - Number of baths---� Lot size ----- _._ -P- -.-.-.L1--f-------------------- Water Supply: Public system [ Community system ❑ Private ❑ Depth to Water Table ------ - ft Character of soil to a depth of 3 feet- Sa/d�E1,- Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Hardpan ❑ Previous Application Made: (If yes,V e_r.�.- ) No ❑ New Construction- Yes [j No x FHA/VA., Yews )( No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) I Septic Tank: Distance from nearest well Distance from foundation__------------------Material ------------------------------------_--------- r o. of compartments----------- ------------Size-------------------- ------ --Liquid depth-------- -- --- ---------Capacity----------------------- ommeld:�/ 1?istance from nearest well-------- ------Distance from foundation--------------------Distance to nearest lot line----------------- ❑ P Number of lines 's-------------------------------Length of each line--.-----------.---------------Width of french-----------------------.----------- �11,�r Type of filter material--------- ---------------Depth of filter material-------------.---------Total length-------..----.---------------------------. Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line--.-------------. ❑ �: Number of pits--- ------------------Lining material------.-------------.- Size: Diameter----------------- - -- Deft h--------------------------------- Cesspool: - -----------------------------Cesspool: Distance from nearest well ----------------Distance from foundation... - ----------- ..Lining material----------------------------.--.---- .•` ❑ Size: Diameter- -= ---- -- ----------------Death------ ------------- -------- ----------------- _Liquid Capacity. - ------------------------gals. --------------------Distance from nearest building 1 Privy: Distance from nearest well----------------------- -- -..g------------------------- ---------- �! ❑ Distance to nearest lot li ------------E-- ---- - ------------------------ Re deli and/or re air istan �{ g / p � i (descri 'e}:- ---- ----- 1�c C�-i-2C'r��F:%-Zc- ----��'r��j-�f-- ' � 1 - ------ ---------------------------------------------------- --- I--------------------------------------------------------------------------------------------------------- ------------------------------- ordinances, State aws, and rules and reguthis as li the San Joaquin Lo_----_-will----------------------------------------------------an - in ----------------- I hereby certify that I have prepared this application and that +he work will be done in accordance with San Joaquin County ' Local Health District. (Signed)------ --- ---- ----- -------------- _k..1!✓ ---------- ---- ---- -- ------------•------------- - ----- -------------------- - --- {Owner and/or Contractor) ---- -------------------------(Title) E' ... . ---- --- ........ (Plot planyN " si a of lot, to do ysfem in ation o wells, buildings, etc., can be placed on reverse side). D RTMENT USE ONLY APPLICATION ACCEPTED BY.------- - - - --- - ------------ ------------------------- DATE- = = -------------=-----•-------------- REVIEWEDBY------------------------ - ---------= ----- --- ---- ------- --- ------------------ ------ ------------------- DATE----------------------------------------------------------- BUILDINGPERMIT ISSUED------- -- ------------------ ---------------------------------------------------------- --- ------ DATE------------------------------ ---------- --------- Alterations and/or recommendations! ------------- --- - -- -- -------------------------...---------------------------------------------------- -------------- j ------------------------------------ -------- ---------------• ------------------------------------------------------------------------- - --------------------------------------- ----- ---- -- - -- -------------------- -------------------- --------------------11-1- -----------------------------------------------------•------------------ --------•------------------------------------------- ---------- - - ------ ---------- ------------------- ------------------------------------- --------------------------- --------------------- FINAL INSPECTION BY:.--------- . ----- - -- -- - -- ------ ------ Date - --------------------------------- S -------------------------------S N OA IN LOCAL HEALTH DISTRICT 1601 E.Hoselton Ave. ( 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California II Lodi. California Manteca,California Tracy,California E.H.9 2M 1.67 Vanguard Press 1