71-589 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT ;N q - --------•----'�--'------ Permit Na. (Complete in Triplicate) �-------------?-/- 3, Date Issued --60-117/ -------------------- This Permit Expires i Year From Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: JOB ADDRESS/LOCATION -_ � --- � - � -7- -CENSUS TRACT -------------------------- Owner's Name --- , ' ----- =-------Phone --------------------------•--------- / / Address ----,� � �-------------------------------------------- City , - Contractor's Named - -+ 1 � . --------License #/ - Phones Installation will serve: Residence Apartment House❑ Commercial ❑Traile=r Court ;❑ Motel ❑ Other ---------------- t Number of living units:--/----- Numbe f bedrooms119----_Garbage Grinder - - Lot Size _ '��'��---------------- Water Supply: Public System and name ------------------------------------Private ❑ Character of soil to a depth of 3 feet: Sand'❑ Silt❑ Clay .❑ Peat ❑ Sandy Loam ❑ Clay Loam A''_ Hardpan E Adobe'❑ Fill Material`-. . ..... If yes,Ftype ------------_-_-----_----- (Plot plan, showing size of lot, location of system in relation to wells,'buildings; etc. must be placed on reverse side.) \t NEW INSTALLATION: (No septic tank or seepage fpit permitted if public sewer is available within 200 feet,) / € ] PACKAGE TREATMENT SEPTIC TANK' Sixe- ;1 ��----------------------- Liquid Depth - --_ ---___.__-._--_. , . Material-de-WW"'-___ __ Compartments _-Z- LJ Capacity�,�� ---- Type: �,�' No. Distance to nearest: Well ------------------------------------Foundation Prop. Line r. ---- ------------ 1 LEACHING LINE Length of each line _ ` ` ---_ Total Length _----_-No. of Lines ___ ----_______. --: 1 r D' Bo Type Filter Materiae_ --_Depth Filter Material ��-----___._-_---__�..-_-.-_-_._ DistanEe to nearest: Well -----gin_----r- Foundation _ ---------- Property Line................ SEEPAGE PIT Depth ---- Diameter s ----- umber---r.- . . - 1149 ILJ Rock Filled YeSA Water Table Depth ---- � ------------------ -------- -------Rock e - ----- _ ------- --- _--Foundation , - ----- Prop. LineDistance-to-nearest:Well---_ _._ REPAIR/ADDITION(Prev. Sanitation Permit# -------------------------------------------- Date -----------------------#_.-_..----) Septic Tank (Specify:Requirements) ------------------- --------------------------------------------------- - '-------------- -------•., ---------------------- a , (asposal Field (Specify Requirements) ------------ - --------------------------------------------------------------- ------' -- ------------------ ---------------------------------------------------------------------- --------------------------------------------- y - . — _ —1 _ ----..., ---------------------------------- -- ------------------------------ ---------------------------------------------------------------------------- (Draw existing and required addition on reverse side)-- ., I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or licen- sed agents signature certifies the following: } "I certify that in the performance.of the work for which this permit is issued, I shall not employ any person in such manner as to become subject to Workman,4'Compensation laws of California." Signed ---- ------------- ---- ---------------- ----------------------------------- Owner ----- -------------------------------- -Title ------ - ------------ - ----------------------- (11 f e than own r) E ART T USE ONLY `J APPLICATION ACCEPTED BY ------- ' : - - - ---------- --------------- y-------- . DATE X2,1--~--7,------- BUILDING PERMIT ISSUED ------- --u- = ------ --------------------------&---------- DATE ADDITIONALCOMMS TS ------- - -- ------------------------------------------------------------------------------------ _ ----- ----------------------------------------------------- - ----------- - - .---------- - 7- ----( ----- ----a^ - -------------------------------------- ----------------------- ------------------------------- ------------- ----- -- --- - - --------------------- ------------------------------------------ ------- - --------------------------------------------------------------- . --------------------------- ----------- Final Inspection by: ------- - _ =; ------ -'=_ ----Date ------ -- --------- JOAQUIN LOCAL HEALTH DISTRICT E. H. 9 1-'68 Re