68-953 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE-., PLICATION FAR SANITATION PERMIT � � - ... p� ---Permit No. ---- t 4" -- - `'1 lGomplete in Triplicate) ��,�t- I -- --- -- --- -� ------------------� �I��1'� } � � Dafie issued -------- ----- - r i -- -- -- This Permit Expiresk 1 Year From Date issued ------------- ------------------------------ # t Ordinance No. 549 and existing Rules and Regulations: to the San Joaquin Local Health District for a permit to construct and install the work herein Application is hereby made liance with County t described. This application is made in comp CENSUS TRACT --------•-------'-------•- C-AR_1�114-ff� [ . /q- � �A Phone AP� E JOB ADDRESS/LOCATION - } L°.1fw_s Owner's Name �.- � j7N--------. City ------ Z License # 1�----- Phone Address t t .�: �--5-�-- --� � ---�----- - - - -- -� i Contractor's Name -.---- ., Commercial railer Court .❑ Residence ❑ Apartment House�❑ 1 Installation will serve ______ �. * `Motel ❑Other - -- --- -------- d Lo# Size �----------------- ---------- -----'------- Garbage Grinder --------- Number of Number of be ---- ---= = -------- -------Private ❑ Number of living ! --------------------------------------------------------- -- - --• ---- ---- ------ -------- I Public' ystem and name ---------------------------------'i----- -- peat❑ Sandy Loam ❑ Clay Loam Water Supp Y th of 3 feet: , Sand'❑ Silt Clay ❑ p �� i Character of soil to a dep _ - Ype ---------- "------ + Hardpan ❑ Adobe Fill Material --._------. Yes, �- laced on reverse side.) I s must be (plot plan, showing size of lot, location of system in relationermid if wells, buildings,r isavacil available within n200 feet,} i I ' NEW INSTALLATION: (No septic tank or seepage pit permtt p , Liquid Depth y SEPTIC TANK'tA ze X l -�---- '.. - .,- ---------- PA( L KAGE TREATMENT [ No. Compartments Motorial l r" + Capacit � Q� TYp �: Y 3 � � �-- Prop. Line --f- -- --- Foundation -7- F I Distante to nearest: Well _- _ Total t Length /---d Q ¢ 610- 14 No. of Lines ._ Length`-;of each ;rine. C LEACHING LINE [ l i. 2�QcrC-_Depth Fi ter Material -1- 1--i ' D' Box -- - _ T e Filter Material �..----- f Property, �� Yp Fou dation -e-- Distance to nearest: Well Rock Filledln Yes '� No F tr . Number -�J ' SEEPAGE PIT [ } Depth . _ ��Pep = Diameter - 1 1� ° Rock Size17 � -s -=_ ----- WaterITable h ---7 .°v Foundation _��----- Prop. Line --- ....... to nearestel1 -- f.- _ } l ` 1 t= -- Date ------- ` + ------- REPAIR/ADDITION(Prev. Sanitation Permit - --------------- ---- -----------"----- ' - ` -i - - i Septic Tank [Specify Requirements) --- ----- -------------- ------------------"--- t r " -- ---- Specify --------------------- - e Requirements) ------- --------- Disposal Field ( - -�!" ------------'-- w F - ----- --------- - -"" - I (Draw existing and requi Fed addition on reverse si e ill he done in accord c I 1 hereby certify that 1 have prepared this application and that the work awuin Local Health District- Hometowner or I ten r County Ordinances, Stare'Laws, and Rules and'Regulations of the Sai- - — — .._- � — sed agents signature certifies the following: perml is-issued,`{ shall not employ any person in such manner "I certify that in the performance°of the worts for w§ich this p N ` Com ensatio aws of California." r as to becom su 'ect to Work an,s p - Owner�w '` l . --------- Signed - -- --- - Y a Title - .- 4 . --- -- b 4- If o r than owner) i " ' FO SPAR INT USE, ONLY" � �. s. 3 - ---- ----- ------- DATE .--.- -- ------- ----- = f ., t ---- ---- ,Y ,. • 4, --- DATE - ,-.{-_:: APPLICATION ACCEPTED BY -------- ---------- --g. . - - ---- I _------------------------------------•-- -- BUILDING .PERMIT ISSUED ---------- = � k_ _--___------.-._ ------- ADDITIONAL -�--- ----------------- ---------------------------------------- ----_:- ADDITIONAL COMMENTS ---- -------- ---- ----�------------------------------_ -- ----- ---- --- - ----- -------------- --------- ----.: l ----------------- ------- --- - Date j f b -------=--- j�,�� N -- - Final Inspection by: ---- ------------ '."� SAN JOAQUIN xLOCAL HEALTH D1STRiCT E. H. 9 1-'68 Rev. 5M