SU0012237 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ---------------------------------- APPLICATION FOR SATATION PERMIT...N---_------------ Permit No. / J. ----- ....... ........... ............... (Complete in Duplicate) ----------------------------- ............_---------- This Permit Expires'I Year From Data Issued Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein scribed This application is made in complian 1*1th nty Ordinance No.,549. 2_o(,_4nPo_o(, 64 W / ICSP. lf�� - JOB ADDRESS AND LOCATIOR-4FIAE....... ......FREN.C.H... MI'..... D , T.7......Rp. A-11 Owner's Nam.. ..........2&/.��LE.UE_rH.......... -------- ................... Phone---.................... Address....... R-m......-1.............So x....... ...5.--------•--------......•--•...... ...... ........ Contractor's Name.....C1WAIZR-----------................................i""Ill,",-..............---------------------------1-11 Phone------.........------...._..- Installation will some: Residence [71Apartment House [] Commercial [] Trailer Court 0 Motel [] Other 0 Number of living units: -1.... Number of bedrooms 2.-.—Number of baths ........ Lot size ... ................ Water-Supply: Public system [3 Community system E] Private [tf Depth to Water Table ... ft. Character of soil,to a depth of 3 feet: Sand El Gravel E] Sandy Loam [] Clay Loam [I Clay 0 Adobe[] Hardpan C] Previous Application Made: [if yes,date--------- ----- __) No 9' New Construction: Yes 0 No 2�_FHA/VA; Yes ❑ No Fr TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well.._:.� .Distance from foundation-_10------ ...... 21� No. of compartments......... .........Size._ Liquid d6p.th....... Capacity...__V,�" ..' Disposal Field: Distance from nearest well-,-.50.....Distance from-foundaiion..._10......Distance to nearest lot line... Number of lines........_ gth of each I;ne___,5F._0-------------Width of trench..._------3677.......... Type of filter materia.........!2.!iZ_KDepth of filter material--- ---- Total length.-.------------- ................ Vj Seepage Pit: Distance to nearestlfrom foundation.....Z0........DktancqAo nearest lot line..--- Number of pits.....(---------------Lining mafariil.,qn.cr.K�--.Size: Diameter.3k'_L/....Depth......... ....... Cesspool: I t Distance from nearest well.................Distance from foundaf;on...................Lining material................-.---.........._.._ Size: Diameter--- , D;pfhA,.......................... ..........Liquid Capacity-....•...................gals. 0 L T - 1�-----------------------_ I , Privy: 'Distance from nearest well..............A.... ....Distance from nearest buildin ------------------_-_----------------- 11 Distance to nearest lot line....--..--_..................NZ. .........r-1-----------_------------------9--....-----_----- ---------- Remodeling and/or repairing (describe):...... ..At-C-r......55_�`V 15.7 E�:-M...... ............................... .........................__-------_....---------•-------........)2.-L.D.-. 16 -------------_----------------------------------------_---_--_------------------- -- .............................................-1................................ -------------------..................................--- -------- ---------------------........ ------------------------•---------------.------------......-•-......-----------• -------------------------------------........................................I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, an rules. and regulations o th an Joaquin Local Health District. -------------------------------------- ------------------(Owner and/or Contractor)— (Signedl.......................rcof_l. .! . ....._ BY:............................................................................................. ------------ __(Tilf le)--------------------------------- .......................... (Plot plan, showing size of lot, locefion of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--------....FAK_.0..,.------------------ ----------------------------- ........... REVIEWEDBY---......-....... --------------- ..__........... ...-.._....-...._.__.-.•--..............__... DATE--------. . ............................................. BUILDINGPERMIT ISSUED------------....._.....----.........._------......._.__....................----------- DATE................................... ................ Alterations and/or recommendations:..---- -------...-•------- .... .........;.................................................................. ---------I------------------ -----............. . .........................-----......•---....................... ......._---------__..................._------..--------- -----------------.... ................_...................-------1__-----------I---I---- ...... .........-.----------•---•V..........................I................................I....................._._.___.------ .............................. ................ ................... )•--------------------------__........ .................................................................. " Xi .......... . .. ._------------ ............................... ................................. FINAL INSPECTIOZ.... Date ............ -/D .......................... SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hwollon A". 300 We,f Obk Sl,eet 124 Sycamore Sfm.i 205 W"t 9th St. 5"hm,calif6mic Lodi, California Manlew,California Tracy,C010091110 _16.