Laserfiche WebLink
7 q <br /> APPLICATION FOR SANITATION PERMIT Permit No. ) / <br /> ' @n �� ^ <br /> r7 (Complete— ---` Do�o |mmno `' / <br /> . <br /> is kem6v made to the San Joaquin Local Hoo|H` District for u permit to construct and install the work herein described. <br /> This application |, made in compliance with County Ordinance No. 549. <br /> � <br /> 1/10 ---------------------------------I-----I'll,------ <br /> - <br /> |msfallation vill serve: Residence L] Apartment House E] Commercial �r �� � Motel � ��r � <br /> ~ <br /> Number ofliving units: -------- Number of bedrooms -------- Nun`6e, of baths Lot size - �-----._.__.__ <br /> Water Supply:, Public system El Community system El Private to Wafer ������ � <br /> Character of soil to mdepth of 3 feet' Sand Ej Gravel 0 Sandy Loam E] Clay Loam E] Clay E] Adobe &"4urdpanD <br /> Previous Application Made: Yes [-] No a~-_'NewConsfruo+inn.- Yos ��' Nn �] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: ' ^ <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well------------------ from foundation---- --- ----------Material --- --- -__________ ' <br /> � n No. of cnmpurtnnon'to--------'Size--'---------Uquid depth----------(�upacJt�_------. ^ <br /> Disposal Field: Distance from nour�o well _-':....Distance from foundation -'-'-'''Distance to nearest lot line--_'___ _ <br /> � Number Of QneS''� ...... ---------------- <br /> Length of each line------------------------- ---Width nftrench'—''---'-_____ <br /> Typa of filter material-------------------------Depth of filter material -.-----Tota| |onof ---------------------- _____. <br /> * Pit: Distance to no*n,sfiwelL--'---Distanco from foundation '''--'-- Distance to nearest lot line''_-_._ <br /> [] Nwmb=r of pit`-+-----------Lining material ---- ---- Size: Diameter _-----..Dopth- <br /> osspop; Distance fnzmfound ^�4�� <br /> Size: D|u �� �� �� ^����� D, - ' id Cu <br /> Privy: D�st nco fro 'Well ' --------------------------------------------Disf nco from 'nearest building ~��. <br /> [] <br /> Distance fo nearest,lot |;no------------------------------ -------------- ------------------------ ---._-__________.____.- <br /> . <br /> ' r ^~~�~ <br /> -� ����--����--_.-__---__.._-_-_'__-__--_._-_-__- <br /> '_-----_---_--'_.--_'_-----_---.-`.---�-----__ <br /> ---------------­------- ------------- � <br /> .--_-_---'---_-_-__-___---__---_._--_---.---_--_-__--.-_-.----._------- / <br /> ordinances,I hereby certify that I have prepared this appli�afion and that the work will be done in accordance with SaeJoaquin County <br /> . State laws, and .~... and regulations of the San Joaquin. Local Health District.. � <br /> (Plot plan. show ing si�'e of lot, location,of system in relation to wells, buildings, etc., can -be placed on reverse side). <br /> _,,.,,EPRDEPARTMENT USE ONLY <br /> � <br /> �PPLC�T|{}N �CC�pTED 8Y' .� -------------------------- <br /> ----------------- <br /> -------- <br /> '''— ��TE'-x���°R�� -_--__ <br /> REY|EVYED 8Y----_----/^..~' �- -----------'_-_-___. DATE',../--_-..~—�-______ ^ <br /> BUILDING PERMIT ISSUED---------------------------------- ------------- ----------------- -----' ----------'''-'- DATE'.--''-'-_-'-'-______.___ <br /> Altm,ufiono and/or nmmmmon6a+ionm ------------------------------ ---------------------------------------------------------------------------------------------------------------------------- <br /> ------------ --``------- --``�----------------------- ------- ` ------- ����`�--------------------------------------------------------------------------------------------------- <br /> ----------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------....... <br /> _�__�����_--- -------- -__-----'�------------------------ ...... ---__��_---___---___----__---__----------_---_--------------_------_--------- <br /> . <br /> --'--''--'''--'--'' ' '- ' ''—'''-'''-'''-'''-''''-'— ' ' -------''------- <br /> FINAL INSPECTION 8Y:,��—/v����/����'~. '�-'''-' Date-- ----------------------------- <br /> / <br /> ' <br /> SANJOAQU|N LOCAL HEALTH DISTRICT <br /> /v* South Ame6tan Street 300 West Oak Street /32 Sycamore Street 814 North "C" Street <br /> Stockton. California Lodi, California Manteca, California Tracy, California <br /> ES-9-2M °"°^=~""" ."= <br />