22308 - Laserfiche WebLink

Home Browse Search

FOR Q.FFICE USE: , . , - ---------------------------- ------------ �» . .. .................................................... APPLICATION FOR SANITATION PERMIT Permit No. . P_✓�_ --------- -----------------------------------_ ----- - (Complete-in Duplicate) Date Issued Date Issued This Permit Expires 1 Year `Z-Z� -- p3a,l� - - --------------------------------- Fram Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. ; _ . T is plication is made in compliance wi h County-Ordinance No. 549. JOS ADDRESS AND LOCATION. .-.SI_DE ------4ANDS_ ::. Y90 / 1 — z '1T A ----------- Owner's Name----------------G -------- -------- .....................................---------------- Phone----------------------------------- 215�0 Address------------------- - - -- ._. Contractors Name-- t-1-E-------P-R-�CA ----- Phone------ -----------•---------------- ---- ----------- ------- -----=----------------------------------- Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ r Number of living units: __ ---- Number of bedrooms__.- Number of baths . ----- Lot size ___ P � - ----� ------------------ -I----------- I Water Supply: Public system ❑ Community system ❑ Private MDepthito Water Table /0_ ft r. Character of soil to a depth of 3 feet- Sand -ravel ❑ Sandy Loam ❑ ; Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan [ (A Previous Application Made: Ilf yes,date--------------- _.J No New Construction: Yes No ❑ FHA/VA: Yes No [ C. TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well--5.P------Distance from foundation----./P__---_Materia �C No. of compartments__.__.;?-_____._.__Size_Vr/V_x__ .___Liquid depth__ ..Capacity..../J-po--- Disposal Fie d: Distance from nearest well.__.5-0._-_Distance from foundation--.._IO_..._.._.Distance to nearest lot line_________________ ❑ Number of lines _� _._ -�-rLength of each line__ ._ _..rl� _.Width of french 2—L �r_.._.__.___t.__.. yn Type of filter m erial\ -_Q - _ .Depth—of af,:filter-ma#.er•FaL-_._� __`_`______Total length-_-- --- __.._____._ 41 Seepage Pit: Distance to nearest well_....................Distanee from foundation-------------------Distance to nearest lot line----------------- -Number of pits_ .__._____..___':Lining material?_.``...... ` SiSize: Diameter---------- --- --------De th=------------------- ❑ Cesspool: Distance from nearest well .._...t___...._ Distancp e•from foundation_________________ __Lining material----- _ _ --- -------._________ f Size: Diameter- -- ---------- -------- -----De Dept _-;------------------------------------------Liquid Capacity----------------------------gals. Privy: Distarce�f om nearest well------------- -------------------------------Distance from nearest building______________._.______.____.._._..._._.` ❑ Distance to nearest lot line -------------------------------------------------------------------- -------------------------------------------------------------------- Remodeling and/or repairing (describel:-------- ------------- - -------- ---- ------------------------•-------------------------------------.....---------------------------------------------- ___________________________ ______._. _________..____-____. -----------------------------------------------------------.--._..__.___-____-._____--.--_-..-_.-------- _!___- — -- . f . ________ __. r _..__.__.' -------------_---------------------------------------------------------___-__.___--__--_______.._____.________________________.________._________.__________.____.___--_-.__._.-_--.._----_-_--..-_-_------ 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. ' .(Signed) - -• - - - - ------•---------- ► — --=---=-(Owner and/or.Contractor)--�.� BY= ----- + : ----- R T (Title) (Plot plan, showing size of lot, Iocatio of stem in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY -(-R `C?-- -------------- ---------------------------- ----- DATE- -I `� ------ REVIEWED BY-------------------------------------------------- --------------- ._...----- DATE------ --------------------------------------------------- - - --- - - -- - BUILDING PERMIT ISSUED---------- ------------------------------------------------- ---------------------------------------- DATE--------------------- . Alterations and/or recommendations:._..- --------------------- -----------------------------------------------------------_---_----------------- ------•------------ --•----------- -------------------------------------------------- ----- ----- FINAL INSPE -- _ '1 Date........ ? SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9Th Street Stockton,California Lodi, California Manteca, California Tracy,California E.H.9 2M 1.67 Vanguard Press `��