Laserfiche WebLink
kt <br /> f POR OF CE us <br /> APPLICATION FOR SANITATION PERMIT <br /> lCompiets in Tr;P cehH fi�rr�it IVa. ✓ ............. <br /> 1= <br /> Doe Issued3 / <br /> •' ./.'fL l I��s l" M.Permits Ewe_ stet I Yew From Dsls Ia%wed <br /> Application is hereby mode to the Son Joaquin total health District for a oe*rn:! its Construct and instal[ the word[ herein <br /> described.this appkaticn is mode in comot=ante wird+ Cevnty Ordinance No. 540 and existing Rules and Reguiatlort>< <br /> p - <br /> Jog AdDR1:55/iflCAT10Ik CENSUS TRACT ....... -•- °' <br /> Owner's Nome /yi .,yT.,� �`/U ...... . --------- ------- - -- - - Phone . . ............ _ <br /> E Address ..1� �h moi' .�'SG/ti' /'v... - -- --- -------- <br /> ._. ._License # F"ne <br /> installation will serve; Reside!xm X.Aporhr»rnt HouseQ Carr+rnerC�arrailer Court Q ` <br /> Motel Q Other <br /> !+lumber of living vn+ts: / Number of b---dr-"ns Grindtr/ 'd:1 . . Lot&Z, ...... <br /> Water Supply: Public System and Home . __-- ... ...._.------»...-------------•----------.----Prhmra� <br /> ,harocter of soil to o depth of 3 feet: Sand Q Siit Q O Q Peat C 5ondy Loom❑ Gay loam Q <br /> Hordpon Adobe ER, !Ill:.tialerior If yss,type- .--.--.-.._______. '- <br /> (Plot plan, slowing size cf lot, 1•,x_tion .5f system in reflation to wd.s. buildings. etc. must 6e placed qts rwerse side.) <br /> NEW INSTALLATION: (Nc septic ton'• seepage io permmed if public sewer is available within 2W feet,) <br /> PACKAGE TREATMENT ( ) SUM TANK T : -"mc._._.----- __ _..... . . ...... . ... Liquid Depth -._�_.... .. ......�. �! <br /> Capoc+ty -.__ Type .. ...__._.___._ Materiae.._ ....... Na, ..nrnpartetsents ...... <br /> aictonoe to r+es>ress; well -_ <br /> Prop.Line ;" <br /> _. Founds+on .. - --•_ _.._....�.� <br /> LEAM41NG LTNE ( 3 -Io. of Lanes Lt:.wh of coil, line Totor Length <br /> V Box . Typo Filth fJsalea of - ......r_.._. _Depth Fvlw Motrtriai ......... <br /> Distance to neorest, Wt!il __. .. . Foundation ..........-... property Line ...... .. ^y <br /> i Yes No :5 <br /> r Nurrsbr stack Fi led Q <br /> Dio!r+etsr _ <br /> ,EEPAGf <br /> Depth . ----. -< <br /> f 1 WOW Table depth ...... _.._....Rock Sue <br /> oistonce to Prop. Litre..... ' <br /> REfAIRJADDITIONMrev.S-nitatien Terttut4f Dora ) <br /> i Septic Tonk fSpeeafy i.pyvirt*r+ert►sl _.:._. _._.......... <br /> ........ _.. ......._.... ^ '$ <br /> Disposal Pioid (Sowfv VeWireRr404+ts4 1 C,�. .0 /.CC ��/>I� .<_ IID._ •,a7 il.. ��. `c <br /> .... . .. .. ..._...,,.._._...._.,.._._....................................................................... <br /> (prow exwing and regvi"4 addition on rswne <br /> f I Mrd► aHwo chat I be"Poe" slab oppacatien eusd abut the wrk wO be dose ke emdesst+ wftfs Sass le4 IN <br /> f C&uWy Ordlsssnevs. $wte Law16 =W IWIG 6Ad Regvlaerews of ahs Sew"ORWIa 4esd 14WA*k1rk.Memo ewnar of NOW, <br /> sed oPewls si/nsatvm cw fias 0*fenowkw <br /> 1.1 C"fy that la Mee pertwwommw of Mte work far wltids Ok parses!Is ilssuad,1 shill net sssPle r afty Persen M sutra srsesrnaf <br /> as M bswetne W 'a Coskperoatiae rows a+Callfereie." , <br /> Signed .... .� Owner t. <br /> :xf r*m r thou aarne+! <br /> V <br /> FM DEPARTMENT UM ONLY <br /> Ar^ptACAilf•J ,t=Tw 8Y T r pATf. -.. _.• <br /> uT Isy" <br /> ADD1TXASM CL1},y�EAi?5 - _.._ _. _.-------._.��. __. . .. r .--• p� .. <br /> '}•/rte � y.�rE.-...� �C►�lt.+/••.......... <br /> ....................... <br /> - <br /> ...............3 <br /> ........... <br /> 1 .� <br /> _...- <br /> Fina!1rsW clraan bys ..,.., _f/i./ry� .�.... . _. ... ...... ....... .-... Dille <br /> SAN JOA W LOCAL HEALTH DLSTRICT f i <br /> E.f{ a 1.'6$Rev.SM <br />