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,tom•..... ..,.. ......... ......._ ._....... �J IN COUNTY PUBLIC HEALTH VICES r ''A E VIRONMENTAL HEALTH DNISIGFri -: i;r' �C.n��`*.-V WEBER AVENLtE�, STOCKTON, CA 95202 InvH �SOA ; j �'� ' (209)468-3420 F J Sjy+ l NON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED (CSIBpIStd In triplicate APPLICATION IS HEREBY MADE TO THE SAN JOAOLRN COUNTY FOR A PEnmrr TO CONSTRUCT AND10R INSTALL THE WORK DESCRIBED, T1418 APPLICATION IS MADE IN COMPLIANCE WITH SAN FI�AOUIN COUNTY bEVELOPMEN7 TITIE,CHAPTER 5-111 Q.3 AND(THE STANDARDS OF/yB�AN JOAOUIN COUNTY PUBLIC HEALTH SJERVK;ES.EN�V{I/R'O�NM,EyN/T/jL HEALTH DIVISION, DDRESSJOR AP`NI I �� /'� 7' �Cl _CITY `� �Fes'7 " LOT SIZEC+T�� OWNER'S NAME,G [Urj �/i _ADDRE99.�y�S� LY� '`�//� /'/ �C`.�� J - - y PHONE /(�101�/�']'Z ��L- —.ADDRESS/2__/__� ��L�'�� '/( �r •-%�-L�I 2f�� PHOHE,S!/f7� CONTRACTOR, __ _ , SUB CONTRACTOR ADDRESS Me PHONE F TYPE OF SEPTIC WORK: NEW INSTALLATION REPAIRIADDITION ❑ DESTRUCTION IND SEPTIC SYSTEM PERMITTED IF PUBLIC SEWER IS AVAILABLE WITHIN 200 FEET OF BUILDING.) PSRC TESThF 1 I HOW MANY y � Appleadon/ INSTALLATION WILL COME' RESIDENCE ICJ COMMERCIAL ❑ OTHER❑ NUMBER MS7 CUMBER OF LTO A D�3 FEET4 OiiBEDROO�J�� UMP SOUMBEREMPLOYEES:IARACT #jWATER TABLE DEPTHof so1C�y Y IL Ct C T KhiHEASE TRAP ❑TYPEJMFO 1 -6L1� CAPACITY z&l9 c5 _ NO.COMPARTMENTS F PKO TREATMENT PLANT❑ DISTANCE TO NEAREST: WELL diO �_,- FOUNDATION PROPERTY LINE i UFT SIATION 11 SIZE TYPE OFF PUMP) SAND OIL SEPARATOR[ENCLOSED SYSTEM) Z LEACHING UNE 1[U NO.i LENGTH OF LINES o'�"yO r �'d' ��- --_.-DISTANCE TO NEAREST:NIELL jn r _FOUNDATKIN,t20 _PROPERTY UNE S0 ..�FILTER BED /❑WIDTH LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE MOUNDED gyp❑WIDTH LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE SEEPAGE PITS �u DEPTH —SIZE 3i 2 r� - NUMBER—�DISTANCE TO NEAREST:WELL / FOUNDATION GJ Z PROPERTY LINE .��} f SUMPS (❑WIDTH LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY UNE T F"DISPOSAL PONDS ❑WIDTH LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE cs I HERESY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE M ACCORDANCE WITH SAN JOAOUIN COUNTY ORDINANCES AND STATE LAWS,AND RULES , AND REGULATIONS OF THE SAN JOAOLAN COUNTY.HOME OWNER DR U SED AGENT'S SIGNATURE CERTIFIES THE FOLLOWING:'1 CERTIFYTHAT M THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 18ISSIfED,1 SHALL NOT EMPLOY ANY PERSON M SUCH NER AS TO BECOME SUBJECT TO WORKMAN'S COMPENSATION LAWS OF CALIFORNIA.- CONTRACTOR'S HIRING OR SUB-CO IND URE C !Fl E FOLLOWING;•1 CERT THA M THE FERFORMANCE OF THE WORK FOR WHICH THIS PERMIT I8 ISSUED,I SHALL EMPLOY PERSONS SUBJECT TO F WORKM ",5% NEAT F C RNIA.' THE ALL 24 HOURS IN ADVANCE FOR ALL REOUIRED INSPECTIONS. COMPL17M DRAWING BELOW. SIGNE % 1 TITLE: DATE: --120—,945 z rr PLOT PLAN(DRAW TO SCALE)SCALP -to i 1. NAMES OF STREETS A ST TO OR BOUNDING THE PROPERTY. 4. LOCATION OF HOUSE SEWAGE DISPOSAL SYSTEM OR PROPOSED 2. OUTUNf OF THE PROPERTY. IMENSIONS AND NORTH DIRECTION. EXPANSION OF SEWAGE DISPOSAL SYSTEMS. DIMENSIONED OUTLINES AND LOCATION OF ALL EXISTING AND PROPOSED STRUCTURES, 6. LOCATION OF WEIIA WITHIN RAMS OF ONE HUNDRED FIFTY FT,ON INCLUDING COVERED AREAS SUCH AS PATIOS DRIVEWAYS AND WALKS. T14E PROPERTY OR ADJOINING PROPERTY. ....................... ... ... ..... ....... ....,.:.,. ......: -__ -;.......,...... : ...... .. - - Al .............. . .. ..........-... I ............. .............. ....... ............... ............ ......... .................. .............. ....... .......... . . . . . . ........ ............. ....... ............. ....... ... ...... . ................. ...... .......... ..... ........... ...... .......... .... ................. ............. ....... .................... - - -- - -- .. - .. .. ... .....:... ...... ...: ... .. .. i ............. . . . r. ..... ... .... .... ....... .. ..:.... - ...1.: ..... ... ... .. .. .. .. .. .. II .... ... .--....- ....................-- .........:a��.- - .. - - .. - .. .. .. .. .. F ............ ...... ....... .............. ........................ .......... . ... .... ................................ ..................... ................. ................ ...... ... .. .. ......... ........ ... ....................... .. . ........... ............... .. Ag ENS`. 5 �/.�y v�... ; fx '. +may SAY 2 2 1998 SANJU 'N ...-. n ..p�,. etUB�i" °1E� 'ThiSERC3 . . 1 FNd1RnGl^IrAtLFH.plvisioP�...