18169 - Laserfiche WebLink

Home Browse Search

FOR OFFICE'USE: ' APPLICATION FOR SANITATION PERMIT Per y - �- E mit No. . .. --- --- --- --- ---(Complete in Duplica+e) ��. �► E �wr4-v r - This Permit Expires 1 Year From Date Issued Date ls2sued ...11._l._.Q. gfl Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein 0-s-2-ibel This application is made in compliance with County Ordinance No. 549. I. r,�� r � � .r A r r f� JOB ADDRESS AND LOCATIONVV�G-t•-(._.M��4-----t-R. --------- �- `.-f-- 0'F-------L�dCTHEhBZ_F .../,K-. RD, Owner's Name------------------- I'.-l-Ri r=+-N--n 1 - Phone Address _ � -------- I - ------------------� -t--------- 57-0_7-------------------------------------------------- ' Contractor's Name--------- ° -` � _ '7 ==== = ---=- =•---1---- ----------------------------------------------------------- Phone----------------------------------- Installation will serve: Residence ❑ Apar meat House ❑ 'Commercial µ❑ pTrailer aF# �MoteE ❑ Other ❑ Number of living units: . ..._._ Number of bedroomsr. N -- umber of baths --1 Lot size _x - ��f r� Wafer Supply; Public system ❑ Community system ❑.% Pfr iate�JD`bepth to Water Table ft. I Character of soil to a depth of 3 feet:,. Sand eG,ravel.❑ Sandy Loam E] Clay Loam ❑ Clay C] Adobe E] Hardpan E] Previous Application Made: .j.lf les,date--------------.-----I No New Construction: Yes o El FHA A: Yes El No TYPE OF INSTALLATION AND SPECIFICATIONS: " "`-""'^{Nd septic tank or cesspool rp itfe`d'if public sewer is ava`�ilable within 200164.)` -T .' - Septic T�nki Distance from nearesf well._= ��____Distance'from foundation----/V—_--..__ Material... - ---------- No. of compartm- e-7n't _______Size._ :---Liquid depth___ _ __ _________Capacity.--' Disposal Field; W Distance from nearest weli_._Si °.__..Distan a"#rom foundation.__/,_1_--------Distance to nearest lot line-----6 Number of lines-!--------- __ . length of each line Width of trench......... rt / Type of filter material.-IRC7_L . Depth of. filter material1Ak _.__.__! _-___..-Tota f. length------_-------- ,t-, 5.-.-._. C Seepal A it"- Distance to nearest well-----___------ -=DistanEe, from foundation---------------01 Distance to nearest lot line--------------- "R,,;-% ❑ Number of p,ts.-# - --------------Lining material-'_-" -----------Size: Diameter___ _----------- Depth. -- --------------------t ! Cesspool: Distance from nearest well------�.-_. __.Distance rom'founclation------... .Lining material_. _-----------------------..... .. I 1 Depth - -.Li uid•Ca acit Size: Diameter.-:'-------------.------__---- �• p � - :- G A Y---------------------------- Privy. --------------- -- ---•-gals. Privy:. Distance from nearest-well__-_--_�---;:._."_:."._-------__.I_....-Distance from earesf building,,.............____-------------------- 0 Distance to nearest-lot line R -- ----------- ---------------------------------- Remodeling ------------------ --Remodeling and/or repairing (describe)=---------i-------------------------------------------------- -------------r=----------•---------------------- ------ , - ------------------------------------------------------------------------- ------------------------------------=----------------------- -------- ---� 1 - ------------- �.. I hereby certify that I have preparedthis applies+ion and that'th we ork will be done in accordance with San Joaquin Count I ordinances, to+e laws, and rules and regulations of the San Joaquin Local Health District. t : (Signed) =----- ------ :---------- (Owner and/or Contractor) W (Plot plan. showing size of lot, Iota+ion of system in relation to wells, buildings, etc., can be placed on reverse side). t FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY------ ' --------- ----------------- DATE--------& 6 REVIEWEDBY---------------------------------------------- ----------------------------------------------------------------------•------- DATE---------------- BUILDING PERMIT ISSUED--------------•1 ------------------------------------------- Alterations ,----Alterations and/or recommendations ',/-/---27-6rr*---- - -�-AfK----f/Lr��l�=i5------ is -r-----------•--------------------------------------- -----------------------------------------5 � rAr _ ltd- .;_, x4f _:_. - --•------------------------------- ----- ------- Tr �' --------------------------------------------- --- --- - --------------------- ----------------:-------------------------------------------------- ---------------------------- -- .. -------- ------------ ------------------------------- ------- -------------------------=----- t DatFINAL iNSPEGT�. N BY- .- - - - - �.l% - --- - ---- - - e--------------- SAN -- - ---------SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazetton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street L Stockton,California Lodi,California Manteca,California Tracy,California F.P.r CI. ,