9640 - Laserfiche WebLink

Home Browse Search

� QQ APPLICATION FOR SANITATION PERMIT Permit No. .__r" _-_ ' (Complete,in Duplicate] Date Issued Application is hereby made to the San Joaquin Local Health District for permit to construct and install 4he work herein described. This application is made.in compliance with County Ordinance No. 549. 'f .. "F" JOBADs--AND "L�tT O �---�24��_._NC3 s Street, Stockton Owner's Name -- ------ -- -entz a �._ ��., ----- Address--.-- ------------------ Phone----.Up-- 4 ---------------• _��m�----------'----- , Contractor's Name � AY_.c�_11JT_Cr `�'.___ FP" T_�C---WANK- SERV ICF. --- --------- -----------------•----•---- - --------------- Phone--4P__27Q�+-6 .l Installation will.server. Residence $ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __2--_ Number of bedrooms _____2 Number of baths 2-_-"" Lot size _-:& _9-"_ 14 s I ---------------------------------- Water Supply:''Public_system Commun1t s stem Y Y }❑ Private ❑ " Depth t, WqK Table_ _1Q ft,. .��.� Character of sol! to afdepth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Laam ❑ .Cla Previous Application Made: 'Yes No y ❑ Adobe Hardpan (] ❑ �� New Construction:. Yes ❑—No M(—FHA/VA: Yes ❑ No ❑ RSI laGCmnt TYPE OF INSTALLATION AND SPECIFICATIONS: � } (No septic tank or'cesspool permitted if public sewer is available'within,200 feet.) +' v w Septic Tank..', Distance from nearest well-----Nagle-Distance from foundation___:" p it -- 1O:; Malarial GG BT' ------------------------------ 6'.' -i- -- No. of com a�tments x6�,r r - �----- --------�-Size_-��2---x-��'-- •- Liquid depth-----��-� ---- .- } Capac�tY n-0------------- . � _ _ Disposal Field Oistance from nearest welt._.-Ngl1 _,Distance from f'ounda.tiorf.. -a(�11--------Distance to nearest l t line__.___P___._... Number of lines----_-L--- --- ---- -- -- Len th of eaclii tne" __ _Q k.____--___-- iType of filter material__-S_ - Rk ______-_otalthlen th of nch s � "Qepth of-filter material_-� ],�rt " Seepage Pit:, Distance to nearest well i1XIIIl�..-_"_Distance from foundation_A�_ot--_--_--,Distance-totnear sf lot f'r�e__ 1 x� 'Number of prts__�b_""""__-""_,_".Lining material---ROO}i-_ �+- it � -----Size: Diameter-_'D-- --- ---De'th 1 -2�_.'- Cesspool: Distance from nearest well (• - " _ „ —�_ Distance from foundation__ ------ El _____ _ Linin}g,materia "-_,�_- rte Size: Diameter-,----- - -------------1-Depth-. - = .- ------------------------ Privy:` --- -- y.` Liquid.Ca =------- --- gals. Prry = istance from nearest well"_"____ _ ______ ____- Distance from nearest buildin ± +,_-" g❑ - Qistance to nee est lot line--=----- ---=�- a - �"�''.�--.. � --------------- -------- _" ___________________________________________M1____-___.______ Remodeling land/pr repairing {describe):--------= _ "... '~�l - _ - -'"----- - ------ ---------------------------- - .�,. ..,.. -------•----------------------------------------- ---------------- -------- ------- --------------- �''` ----------------------------- ------- _J_ -------------•---- , i- ---- ------ I hereby, ce`rtif ws, I have prepared this application and that the work will be done in accordance•with,San Joaquin County ordinancf. es, $tate laws,and rules and regulations`of the`San Joa u, �Lacal'Health Disfr011 [SAY &-NIGHT = Si ned �_ f { 9 * } SEPTI-•T-ANK--S�f2tff = B2905 E. Miner Ave. � ----- " { Contractor] M CcZxt#• ---------- -------------------- � - {Title}----•--------- elation - - Plot len, showin sii ___ - -- - -------------------=-------- { P 9 � � s+em in rtoywells, buil ings;,etc can be placed on reverse side}. r _. , �I FOR DEP'TfvIENT USE.ONLY/ APPLICATION ACCEPTED 'BY-- -- r DATE ------ REVIEWED BY' ..... - ------------------ ------------- BUILDING PERMIT ISSUED -> DATE - =- -------- DATE---- \• - - Alterations and/or recon mendations:__'__________________ "" ----------------------------- --- ------- - -----------------------------------------------------"-•------•-- - -----------`--------� -"' � - -tel T- = Tht c� I.CLcS 'ry'_!L�tl �A Ck cp b- --------••--. ---------------------------- ---•----- rn1 .r,l4L. 1i - - - ?°.- --------l4 = • - - --=---------- ��[11'.�_._ ^^ctHca tL.i L(L' . FINAL INSPECTION BY------------- ---"" --- - _ _- " Date---------- -.- SACOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street Stockton, California '� 814 North "C" Street Lodi;,California Manteca, California Tracy, California ES-4-2M . Revised 1.57 F.P.tO. �