SU0004494 SSNL - Laserfiche WebLink

Home Browse Search

..._..............._..........._..............1. `"°LICATION FOR FANITATION PER' 'T Permit No. aVaL y.cp �/ (Complete-in Duplicate) w/ _.......... ..... ._.......... . .._....__.__ This Permit Expires 1 Year From Date Issued Date Issued ....1 Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. r This application is made in comply an a with County Ordinance No. 5499... / JOB ADDRESS ANDrC.E �LOATIO .N..l?.----t-[ Es VAir......./...oF.....I7. Y.......�.D-- ---.._ ........_LAT.... Owner's Name......... .. ,.dc'.........ril.vgi�.......��r l�.�E�.:.. .. . .............................._........ Phone.......E............................ Address...................&.91........vu.....FI"'' rVV.Af�J_ .T......ED.................. ............... Contractor's Name---...QAAL! C C"---.............. .....:.-.................__........_.... ....._.........................._............. Phone................................... Installation wig serve: Residence❑ Apartment House ❑/ Commercial ❑ Trailer Court [)/Motel ❑ Other ❑ Number of living units: .?.... Number of bedrooms .. ... Number of baths .. Lot size -... :C ptfE10C.q.k5................_. Water Supply: Public systemCommunity system ❑ Private ❑ Depth to Water Table it Character of soil to a depth of 3 feet- Sand Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay Ejl Adobe❑ Hardpan ❑\ Previous Application Made: (if yes,date__ _ - - --. ) No45e- New Construction: Yes E5'�o ❑ FHA/VA: Yes ❑' No TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is avililable within 200 feet.) Septic T nk: Distance from nearest well.....:,l.v..-Disten a orn-foun tion__...�U........Material c0n�cRCTE. ttc [� No. of compartments...-.,..:r2.. ......._...Size... :_ �.;u. _Xquid depth.....5...... ...._ capacity.....1J`_.0� Disposal Field: Distance from nearest well_..S.-C.)...Distance from foundatign.....6Q.......Distance to nearest lot li a ms..:.. Number of lines ........... . Length of each line..... ... ._. ��ss . g f A.........-s-....Wldth of French........ .yt' ............ Type of filter material...{5.�1'. r�_...Depth of filter material_.....ZY......_Total Iencjth......................7..Q......... :.. Seepage Pit: Distance to nearest well......r...............Distance from foundation..................Distance tib heart lot fine............ ❑ Number of pits... ......_..........Lining material...................... Size: Diameter.......................Depth................................. ` Cesspool: Distance from nearest well................Distance from foundation................. ..Lining material.."........._.................._ 17 Size: Diameter. .. .............. ................Depth................f................. ..__..:.........Liquid Capacity.................. .........gals. Privy: -Distance from nearest vfell............. ...................................Distance from nearest building....................:.__.__ _ ❑ Distance to nearest lot We_ i0 7 . Remodeling and/or repairing (describe):...._.:d12L %-....��I1/111I__..' /QM -...... C_ 01.W w . .............:.................:.R 7 .� ( - Air �I: C .C? -....4 -'I3`1N:K.........� 1 s�........T..�1At�t----------2 F�� - ..ASFtF.tz....'tHAY ..-_.O.c `c-...."6.F........RRtS iP........ ------ r'C/44------.CAt'&� k.7.. _ M .... ....................... ........................... I hereby certify that I have prepared AIR-application and that the ryotk will be done in accordance with Sa'n JoaquinCounty ordinances, State laws, and rules and regulations of fhp San Joaquin Local Health District ) v`j (Signed). _ ... ..,-..{Own sr end/or Contractor) By:....................................................................._.............._...._.....__._...... ---------- _.....(Title)................. ... ..... ................. _.: -......... (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). _ POR DEPARTMENT USE ONLY APPLICATION ACCEPTE Y.-'./ A.,G - ..._,......._............................:..... .........:. DATE....... 2 REVIEWED BY---•--............ ........YIIA�_D...C.E.fA---PR.._.. ....__...._....._..-- ' DATE__.__.: i.:: 33 ::::�. �. BUILDING PERMIT ISSUED........ .. ......................... ........................_......................._..}......1.. DATE....... ..... Alterations and/or recommendations:.....j....:..:........... :. ....................... .. ........... .................... ................................ ......................................_.............................. .........._....._.............:................_......_.......... .._. ...........I..__...............-._....................................,. tee _. ........:... ........ .........._..............................................._..... .......... ....................... .......I.................... .......................... ..................... .. . ... .............. _. ....... ._...................._.......................n.................../........................--•-----------....-- FINAL INSPEC Q�J. ._....... . . .... Date_........ ed...:�'.. �? SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Haaelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 91h Street Stockton,California Lodi. California Montero,California Tracy,California E.H.9 2M 1.67 V.n9.c,d Prov