SU0002318 - Laserfiche WebLink

Home Browse Search

F.Oa .OFFICE USE, APPLICATION FOR SANITATION PERMfT Permit I,-o. •'7 JC (Complete In Triplicate) J This remit Expir*s T Yam from Date bawd Date bw te%C:. l..lrr Aoplieation Is hereby made to the Son Joaquin local Health District for a permit to construct and Install th , work hernln described. This application Is matte In Compliance with Coupty Ordinance No. 319 and existing Rules and Rigulatlons, JOB ADDRE55/L TION / •31. .......�!'....y. / . .r ' � ._..... CENSUS TRACT ..... ................... ... . ......... ... A Owner's Name .�. ...'�r....... .. . .............._.......................... ..Phone .................................... H .......,.1..... ndrlress 3.d ,37...�,. L1LaG.... ..... .. City .,t .. .....'z....yl.................-._................._.._. Contractor's Noma ............( it,e.rkn'....'f� ... .. .. ................_...........License IF 7(;1, .2... Phone Installation will serves ResiJence(M Aportment House 0 Commercial[]Troller Cwurt Q Motel L-1 Other.......................................... �7 Number of livinga� l+t-QJ units,...(..... Number of bedrooms .,_...Garbage Grinder ............ tat Slits ..rf"............... Water Supply, Public System and name ...........»....................V.............. _ Character of soil to o depth of 3 feet, Sand 17 Sift Q Cay ❑ Peat O Sandy lawn Q Cay loam❑ Hordpon o Adobe r Fill Meatal...»..»...If yet,type_r_. ...._....... r (Plot plan, showing size of lot, location of system In relation to wells, buildings, ale must be placed on reverse side.) NEW INSTALLATIONt (No septic tank or seepage pit permitted If public saw Is available within 200 feet.) PACKAGE TREATMENT SEPTIC TANK()j D /V S,7 �3� �a.�`��px,/................. liquid Depth ...��................. Capacity /RO-Q........ Type I . ..!.'.......... No. Compartments ....91......_.. r- i r Distance M rpearesh Well ..� ......................Foundation Founclation-410.......... Prop.Line.»,7�.».._.._.. w EACHING LINIE (y' No. of Unes .....3.............. length of each Ilne..`>!4..�..rr!Q...`/4.. Taal Length,.... _........ 'D' Box ...` ... Type Filter Material -,s4Pm.�Dspth Ftitw Mehta) ..Z.46 ...............-............ . Distance to neurosis Well ........� Foundation ...R.A»..._._ R ... aperty Line �` .-............•. SEEPAGE PIT j)f Depth _.,�KS....... Did was Number ...........3.......I— Rock Filled Yes)X No `:1 Water Table Depth .....,,lG.s1................................Rock SW. ..._X.,................ D Distance to nec resh Well ./410.1*... Foundation .. Prop. Line ..s_........ REPAIR/ADDITION(Prov. Sanitation Permit tli......................:..................... Date » -» ...»». ..._..._......................___......,..........»._"� Septic Tank (SPecpfy Requirements) .................................._. .........». p Dsoosal Field (Specify Requirements) .......-...•••-......................... ............. ......... ........................ ..................................................._.........................................».......................................... ................................. . ................................_...................................._.......................---.............._..........P i tDrow existing ondpulred addition on reverse side) _ I hereby certify that 1 have prepared this oppllcano en a. a w'&i,wT-16* done B1 accordance w1:1. County Ordinances, Stab Laws, and Rules and Regulations of the San Joaquin Local Heohh District. Ham* ownw W Rees ` sed agents signature certifies the fell*wing: '•I c*rt.fy that in the performance of the work fw which Ihis permit is Issued,I sbetl not employ any person In such mamm k os to besubject to Lygkmon' ensaflen lam of California:' 9 ; oned �.......�.�..jj��....a ......f}JJ., `"� .. Owner ..... !tom 4 V SLE-7.�7`.......... title .... ' o••..................................................... (If other thou ow erl FOR DEPARTMENT USE ONLY PW r-PtTION ACCEPTED BY ... • _... ...............4 DATE.....�b -..;477..!11 .. ... BUILDING PERMIT ISSUED .. ..... .. ..DATE .. _. ._... /\DOtTIONAL COMMENTS ... . .... . ....__._._._...... ... .._.. ,. 1 .... ....Dab /0/�'/ � .. �.� '+mol inapeclion by � - - "� 1 121, 1-6II li:,v. 5hSAN JOAQUIN LOCAL HEALTH DISTRICT 8/7L 3H