Laserfiche WebLink
"FOR OFFICE USE: r� �y <br /> APPLICATION FCtf! `ANI7AToON PERMIT permit No. .!�!� <br /> _... ........... ... .. t.....I (CumPlale(n Triplicate) q <br /> .... . <br /> ... DON Date issued <br /> This Permit Expires 1 Year'ear From_�od r <br /> ... .pp ............................... -- <br /> 9. <br /> Application is hereby made to the San Joaquin Local for a permit to construct and install the uati heroin <br /> al Health Di <br /> r described. This oppi::ation is made In compliance with Countv Ordinance No. 549/°nd existing Rules and Regulations: <br /> . <br /> JOBADDRESS/LOCATI,(1,�j(•!p .t,'� )� �p '"' / 't <br /> Owner's Name�� '" r.Ur:GC(d�u .,�rV................................._._...:...._Llcensa /...1.%.. -Phone .7. _..-..........._fir Q,k <br /> r G Yr- Cry. e. �.............._.. ...��" <br /> Address ....... <br /> Controcror's Nurne..... i ...-.. //. . <br /> Installation will serves Rai�drnce LT,�pC•arimen.!Hoose r,_] Commercial(]Trailer Court <br /> Motsf C]Other...................... ................. <br /> Number of living units:..........] Number of bodrooms .�......_.Garbaga Grinder✓LtA..... Lot Size <br /> Water Supply, Public Syste and name ............_......................_..........:... <br /> ....._.......................................... <br /> ........P IPte i ,a. <br /> "'� ' 1 peat Sandy Loam[� Y I.oa n <br /> Character of soil to a depth dfa4;itat: :and❑ Si.t O CIuY f] T" <br /> v �.�farff�an Adobe IJFII'Mi.'-'Ial 'f type-...... ... <br /> r. <br /> -- <br /> .e. Y.vT. ...�.m..m..��.�...�•......�m.s�m /. <br /> (plot plan, showing size of tor, location cW_rtem in relation to wells, buiidings, etc. must be place qn reverse side.) r� <br /> NEW INSTALLATIONt (No septic. tank or s.,epage•pit permitted if public sewer Is avalioble within 200 fagt,l to <br /> .r PACKAGE TREATMV,lT O SEPTICTANKr ) Size............................................ .. Liquid pplep1plfs ...................._ <br /> . Type ~ ,...'Material...................... No. Compart/eients ............ illy <br /> Capacity ........ YP •• ... P/oD•dLine..................._ <br /> I - Distance to mrarest Well ..........!y ...Foundation . ..._........... <br /> 4t lion <br /> . Total L r Ih� <br /> . . Len th of 00th Ilm.......................... 9 9 ........_............_ .. <br /> LINE <br /> No, of Linea .. ................ <br /> 9 1 <br /> LEACHING LIN_ [ ) ,,,,,,.. ...... M <br /> ' 'D' Box ............ Type F1L`er Material ..................Depth Fllte Material . I ''. <br /> _... ProlserfoLfne .................... <br /> Distance to nearest: Well ...... ................ Foundation Rs>�JC Fllled Yes ❑ No [] <br /> t Diameter Number ....... <br /> SEEPAGE PIT [ ] Depth .............. <br /> r• ......... <br /> Water Table De h ........ ......Ra;.Jc. .z <br /> FpundoTlon . <br /> - ,—.... T....... Prop. Lino .................. <br /> Distance to n0arastr Well . 4 <br /> M��::::..:::..a•ate ....' ........._. <br /> R_PAIR/ADDITION(7rov. Sanitation Permit f. ........ .t L� ....... <br /> t. ..... <br /> SIP,.ic cents ISpe fy Requlron+enisl .. ............ .... ... <br /> e } j,. �_........_/ !!! 111 .IV;. <br /> Dirpos P:,- d ;. ecify gequlremen sl r�5.s�1 1..._..�... .................. ... ...... <br /> U........ .. ................ <br /> L - <br /> / .. .............................� .. ..... ...... .... .. <br /> ... ... . ... ........t , <br /> ........ ' 'Draw ex sting an required addition on revenaslde , <br /> I hereby certify Lha tprAi;itlti�.t$te_RPPIIcOf,Sr and that the work will be.tdo in accordance with San Joaquin <br /> comnty Ordhsanws, Stals Laws, and Rulvs and RegulCt,ens of thc, San Joaquin Let/1 . eahb District-Home owner or lice <br /> sod agents:Ignoturs certifies.tits� 'law?ng: <br /> "I certify that In thhpadermonz f thn work 'or which this pormit la Issued, I shal(fpt employ any person In such mamsats� <br /> of a become subloct to Wakma s ZompenscOon lows of Cali/ornlo." ,,yay <br /> Owner <br /> Sid d _ ........ .......: i <br /> ... . .... Tele .. .. 4Lr...... . .... . ........ ......................... <br /> jif oth tYuhn owner <br /> I� <br /> FOR DEPARTMENT USE ONLY <br /> DATE ... -:-a5..11.............: <br /> A PL CATION.ACCEPTSD BY.... . . `................................................. ....................... <br /> ... ..D TE...... <br /> 6 ILDING PERMIT WLIED.... ..............+................. �' . <br /> .............. <br /> ADDITIONAL COMMENTS.. <br /> 1 ....r,'YJ .i <br /> .. ..............:.......... ........................._.. .._....................... ......_.... ....................................................................... <br /> T .......................... <br /> �.. .............................................................................p_..... .. .. ...... <br /> Date . .. . <br /> a� . <br /> Final Iropectron hy: . w�,r`-� ..:—:.._...._................ �. <br /> I'- SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> L <br />