15752 - Laserfiche WebLink

Home Browse Search

APPLICATION"FOVSANITATION PERMIT Permit No. 1 ----------------------------------------------- J (complete in Duplicate) Date Issued ... - --------------------------------------------------- This Permit Expires 1 Year From Date Issued 1 .Splicafion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. T application is made in compliance with County Ordinance No. 549. 7�dl T'O ....... 4 ------JOB ADDRESS..AN CtTIO .....J,49- --------752�--------------------------- ---------------------- Owner's Name. ...... ... ...... 41 ✓--------------------- ---- --------------------------—---------------- Phone----•----.......................... Address................................. -. — ..A.Q.-� '7 / - a --------- ---------------------------------------------------------------------------- Contractor's Name------------ •. ............... ...................................................................... Phone.................................. Installation will serve: Residence �Apartment House Commercial [I Trailer Court E] Motel [] Other E] Number of living units: ---- Number of beclrooms�3 SiPA, % -------- Number of batted-___.... Lot "ze ------------------------------------------------------- 5`1 To �-?xjft. Water Supply: Public system E] Community system 0 Private E1Vbep�Maf'e"rT6blZ Character of soil to a depth of 3 feet: Sand F] Gravel E] San oam [] ClayLoam [3 Clay-E] Adobeardpan El Previous Application Made: ilf yes,date___.__.._____.____) No []T Now Construction: Yes to ❑ FHA/VA: Yes El No, TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if publhidiewerjs available--w—ithin 200 feet.) ou ----C.---t--------- --- No. of compartments_.________-2.-- ---Size----.5-(--X------------Liquid depth----- 1,;�z----------Capai .... ......... arlo e-ru—, Septic Tq;A, Distance from nearest well______________ Distance &om I re Di s eld: Distance from nearest well------------------Distance from foundation- Distance to nearest �n ;W1---- I tl/!:� ............. p ....t........ .6�� Number of lines--------- --------------- --------Length of each line---74S7;�1!sS .....Width tf trench S /______________ Type of filter Depth of filter ma-terial----- __________Total length....../-%S—O------------------------ See pag 4"`,�f Distance to nearest well--------- Alatlon /0 0'--Distanco rwD-i9tance.fTom-foui ...... e to nearest lot line--5 Number of pits-----c;��-----Lining material------ -----V�iz e:'Bi are 3-"/----D e p t h...... ------------ t.eCesspool: Distance from nearest well_________ .___Distance from foundation--------------------Lining material________._-.___-___________-__--.--_ ❑ Size: Diameter------------------ ----------- - - Depth----------------------------------------------------Liquid Capacity-----------------------------gals. vy: Distance from nearest well______________ - ------------- -------------Disfance.from,nearest.buji0int. g------------------------------------------ Distance to nearest lot line------------a- - ---------------------------••------------------- -----I--------------------------------------------------------------------------------------------------------------- Remodeling and/or repairing (describe):----- -- ------- -i ----- ------------ -------------- ... .............................. ................---------------------I---------------I-------------I----------------------—--------- ...... ---- --------- -------------------------------------------------- - ----------------------------------------------------------I----------- -----------------------)�---4------------------------ ------------------------------------ ---------------------------------------------- ----------------------------------..-------------t-nft�nt--�-------------------1—1 --------------------------------------------------------------------------------------------------------------- I hereby certify f hat I have ared }his applicafio'n an-edll;'af the work will be done in accordance with San Joaquin County ordinances. Sfo� �and rule and guEations of the San Joaquin Local Health District. --- ------ ----------------- (Signed)------ ---------- ---- -- --- ---- ----- -----------------------------------------------------------------------------------(Owner and/or Contrac+orl By:--------------------------- - ----------- -- -- ------------------------- --------(rifle)----- --------- ---- --- of ysi li s. (Plot plan, showing size of lot, I ca+i of stem in relation to we , uildings, etc., can be placed on Averse side). y k I FOR DEPARTMENT USE ONLY. APPLICATION ACCEPTED BY-------------------- -------------- ------ rL?�' D AT E----------- ----------------- REVIEWEDBY------------------------------------------------------------------------------------------------.......----•- -.-..-------- DATE------------------------------------------------------------ BUILDING PERMIT ISSUED----------------- .......I...... DAT' ; Alterations and/or recommendations: -------------- '00� ------------ ---------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------I....... --------------------------------------------------------- ----------------------------------------—...............--------------—............ ..........-........ ----------------------------------- ------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------........... ------------------------------------------ ----------------------------------- ----------------- - ------------ ---------- --------- -. ------------------------ ----- --- --------------------- - -------- - -- ------ FINAL INSPECTION BY- Date- SAIIJOAQQU LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca;Calif ornlo, Tracy,California ES 9 RMSED U-59 2M 5.6Z ATLAS