16433 - Laserfiche WebLink

Home Browse Search

FbR OFFICE USE: ---------- Permit No. - _ APPLICATION FOR SANITATION PERMIT --- ----------- Al ------------- --- ---. Complete in Duplicate) Date Issued ------------------- - This Permit Expires 1 Year From Date Issued ------------------- ------ Application is hereby made to the San Joaquin LocalHealth District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. [1 , JOB ADDRESS AND LOCATION...... a----------- ----------- - L _ _Q- "----------------•---------------------------------------.------------- Owner s Name--------VY\-1'-Z.-5............--1.__s.ti..�-j�.--------------------•-------------------- ------ ------ Phone------------------------------------ --------------- Address-------------------C.... __ ._ti^!!�e,.� ----------------------••------- --------------------------------------...---t----------•---------------------------"•------ r Contractor's Name -D •"----- ►f_v'_\. `� 5 ----1 �y------------ -----"--- Phone--140-..kx -CA- 0.j4l2`�__ Installation will serve: Residence vul Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other [I Number of living units:i.A___ Number of bedrooms Number of baths ------- Lot size ------- --------------- Water Supply: Public systern'I. ; .Community system ❑ Private ❑ -Depth to Water Table _-Ce ft. Character of soil to a depth of 3 feet: Sand C] Gravel [:] Sandy Loam ElClay Loam ❑ Clay ❑ Adobe Y_ Hardpan ❑` Previous Application Made: If yes,date--------------------) No New Construction: Yes ❑ No FHA/VA: Yes ❑ No TYPE OF INSTALLATION AND SPECIFICATIONS: `, . . (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest ❑ wel ___ -----_Material-______-_____________._-------- No. ----------a�.-- of compartments--=---- -•------ ----._Size------- -----------------------Liquid depth----------------- -------.CapacitY------------- 5� Disposal Field: Distance from nearest well.-W-0- ------- Distance from foundation-----`�..Q_`.__.Distance to nearest lot line..___ ------ Disposal - Number of lines------------)___--- -- --- -----Length of each line______--___-_ice--rS Width of trench_--. _.__-iZ. filter matenaL___2 Depth of filter material-------- l_$_"___Total length_________ ________------- Type Seepage Pit: Distance to nearest well__--1 o_�Nl�._.Distamce from foundation -`.--.Distance to nearest lot Brie 5;13--r o `" ° IC'.Size: DFameter__.__3.3..3i---_.Depth------------- _ Number of pits.---___---_L___-- Lining material-_-`h+.__ :._.,` Cesspool: DistancePq 1rfrom nearest well____ ______--__Distance from foundation______ _________•.Lmmg material___--___.__--____._ G ',r als.'R Size: Diann --------------•.--:- ---- ----- ------Depth ---------------------------- FL'iquid Capgcity.---- --- 9 _ }` ' i Privy: Distance"from nearest-wel---------.__ Distance from nearest building _______ a - - ---------- --- - - Distance'lfo nearest lot Iine--------------------------------------------------------------------------------- ---------------------- '`'7 El Remodeling and/or repairing (describe) 1c�_� - - --- S_T_l a t ` ,�.s.S- e_VII• - - "_" -------------- --------------- --------------------------------------------------- " ----- ------------------------------------- f- I hereby certify that I k _ -------------- i. II ----------- -- -••-=--------• ----------- --------------------------- y y have prepared this application and that the work will be lona in accordance with San Joaquin County fix., - r ordinances, State laws, and."rules and regulations of +he San Joaquin Local Health District. - and/or Contractor) (Signed)_ -------------------------------- ---------------------- = - ------------------------ ------ tion o s stem in relation to wells, buildings, etc., can be•placed on reverse sidd). r n. [Plot plan, showing size of lot, loco y t i f FOR DEPARTMENT USE ONLY - DATE -------------- t Z APPLICATION ACCEPTED IBY------- ---- -- -- --- -- -- --------- DATE--------- ------------------------------------------------- REVIEWEDBY--------------------- --------------------------------------------- 4------------------------------------- - _ DATE- - -: BUILDING PERMIT ISSUED'-_-----•------• ------------- ------ ---------------- Al+erations rid or re co t ndations:-_.____. ---�� - `�"-' i'�r "' Ir ;, , ` y - 3 ! -------------- - -. ----•------ --------- ------- ---------------- - �a--r-f" - - F ��z ----- - ---- - -----------•---------------------- - c ' -- ------ P rye 2-^--: ---------------------------------------------------I---------- -----------------------------•------------••---------------- f -------------------------- - -------T----- ..--------- ------ -------------------- FINAL INSPECTION BYi---------------------- Date- .- --- - -- ii SAN JOAQUIN+LOCAL HEALTH DISTRICT 300 West Oak Street 124 Sycamore Street 205 West 9th Street 1601 E.Haselton Ave:' Stockton,California it Lodi,California Manteca,California Tracy,California i. ES 8 REVISED 8.59 3M 3"'63.F.P.co. i