SU0002167 SSNL - Laserfiche WebLink

Home Browse Search

Ir k- err S� W 7 v��i r�u ti•,o14, '.f. „3 ,"' r a."i t i••- »''- 4,j "�,•,Z'a .+� J 3a �„ -�4 .�rsi .?' a•sy ✓ t'Lai,K }� � � � - _ t � -,�f?r� .,.z; qr�4 �,�tr`} gip•$^f s�` � x3e1� r FOR OFFICE USE: .............................. ............... . APPLICATION FOR SANITATION PERMIT . Permit No q .................. (Complete in Duplicate) Data Issued �_1 t' ... " p _ " This Permit Expires 1 Year From Date Issued A lication is herebymade to the San Joaquin Local Health District for o permit to construct and ink ..rhe work herein described ".This application is made in compliance with County Ordinance No. 549. .-.JOB ADDRESS AND LO.:ATION.Ia _ 1?! i'...4t/ of- X- ...4r, th:z ...................::._ s•,- -. Owner's Name__........ ��... L�_}3J`'1��.?.--••...:. Phane......._._.. _---• .l. �t4._.l..............�.: G.rant- ..,r+- •.............................. Address.-.--.- �4 Cantrector's Namt................... $3.S__ 4� x,< :. 1�0s��........................�'Y_ .�a�t-.....fi�l _ .(17Y4c f ........ Phons Installation will serve: Residence M---'Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units; --- .. Number of bedrooms ..a. Number of baths .�__-. Lot size ....��•-•-••_••••••••• Supply: Public system ❑ Community system 0 Private Depth to Water Table .� ft. - Character of soil to a depth of 3 feet: Send I=] Gravel F_1 Sandy Loam❑ Clay Loam❑ Clay❑ 'Ad abe� lardpan t '•, Previous-Application Made: (If yes,date........--".........'1 No [� New Construction: Yes ❑ No FHA/VA:Yes ❑ No , } TYPE OF.INSTALLATION AND SPECIFICATIONS: _ {No septic tank or cesspool permihfed if public sewer is available within 200 feet.) to ' . r, Septic Tank: Distancfr from nearest well4!� ._..._.Distance from foundation__�0.............Matenal E'.> ..�. s?A No. of comuartments.."....___ Size.. "`...�9.."--� -•Liquid depth........ ..._.Capacify � s , / 0••,•••••-•-.Distance to nearest lot�ine fi�Q ��, w Dispose! Field:. Distance from nearest well-_-�.l?-O.--Distance from ioundattort.I� Number of lines...._._._r .....................Length of each line---.....12A -._..._......Width of trench... .. q / Type of filter matenal_S�p_.�:q_!-._Depth of filter mafenal...Lg.:...........Tota{ length..:...:V �? - ...............Distance to nearest lot line .... �S S` Seepage Pit: Distance to nearest well.....................Distance from foundation..... Depth.....:_.. ❑' Number of pits..................."._Lining material..__......--.....--•--.Size: Diameter......... \ :tsfance #rem nearest well.................Distance from foundation,.""_.......-.....-.Lining materie77 l ...'.. Liquid Capacity...---- __ ..gals...;. ❑. Six;:: Diameter...................................... --•-----•-•---•_--._._... Distal.-e from nearest well.............. Privy: .._.....Distance from nearest buildirsg_________________ ❑ Distance to nearest lot line__.__ _-.-., ......................................._.._......._..._.._..........._.......-_..........._........ s. Remodeling.and/or_repairing (describe):.........................................................................................:...__.......... - . .... ... r . .»....................................... __._....__._...__._........--••-_._._.__......__._..__._....... !.hereby certify that I have prepared this application and that the work will be done in accordance with San JoaquinCountyr .,r.' ordinance:. State laws, and rules and regulations of the San Joaquin Local Health District. ; r yr (Signed) - --. r .............................................•.. :.{Owner an I— Goritractar) 3 r :_._... --------------(Title)....------..._-........__....• - ,. y .......:_--- .__ -•........................................ B �n ;(Plot.plan.stowing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). r : FOR DEPARTMENT USE OWf DATE.....43'_' ..r _ . ....APPLICATION ACCEPTED B , . REVIEWED BY....::............... ...... DATE._..__......_._._ :--_..:' _..................... T --- •-•--- ';-`.BUILDING PERMIT'ISSUED--------------- -- DATE ......................•--.........•.... ........._..__...... ~_~ rations and recommendations:...................._.._._...._.._......_____.- ----'- ,,.... ..................................................... ......................... _......_......... r---------------- /''" Date.."._._S/.._41' ... ......................"._._...._..........___ FINAL INSPECTION B ... •• ...... ............. ... ... %x. SAN JOAQUIN LOCAL HEALTH DISTRICT A7 1601 E.Haselten Ave. 300 West Oak Street 124 Sycamora Street - 205 Weir 9th Street '. `, _s,.41—CaFlrr•,rfq _ Ledr,Califomia Manteca,Cailfornia -Trocy,California _