SU0002655_SSNL - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PF?MIT Permit No. .L.I.-fl--_J_f-. (Complete in Duplicate) & Date Issued -- Applica'.ion is hereby made to t.,e San Joaquin Local Health District for a permit to construct and install the-or'r.herein/described. This application is made in cemplia-ice with C•)unty Ordinance ttn- S49. JOBADDRESS AND LOCATION.......qt+ 2,. . G.X..�.� ....t._A.C.c c Oa A.. .........._..-- ...................... t{ Cwner's Name. ...-Vzrnon ...... . .--21.e•:-1er--------------_.__..... n--..---_--_ _ Phone. ... � -------- Address.................. ------ Address ...srrnsr - 1u? .. e` ^ ti3. nn LL sfae of 9 ii— .• ....-..- ....4.... G• 1 I- Contracn is Name.......... .....rJC�`1,...i=1C.. . Phone '�-3..9.5r..5r-....... _ .__._._......._-. Installation will serve: Re:idence t,� Apa.tment House ❑ Ccmmercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Num'oer of living units: .1 Number of bedrooms_.2 . Nvmber of baths ....1. Lot sae ---134X145X1 27X241x30.... Water Supply: Publi:. system ❑ Community system ❑ Privat- 0 Depth to `Nater Table 40.- fi. Character of soil to a depih of 3 feet: Sand❑ :gavel ❑ Sandy Loam❑ Clay Loem ❑ Clay❑ Adobe❑ Hardpan Previous Application Made: Yes ❑ No E-t Know Constructic n: Yes No ❑ TYPE OF INSTALLATION AND SPECINCAT10NS: p (No septic Penh or cesspool permitted if public sewer is ave6bie within 200 f_-et.) Septic TanK• Distance from oearesi v:ell.....75 Distance from foundation......9..'--.._-.Material._Sr:-ment:brlo.;r. ....... ® No. of cornpertments._ 2_ Size-.2..-.:4'..x4....-----Liquid dep'h-.S---&3 _- _. Caracity..... Jq..... ..- Disposal Meld: Distance from nearest weii Distance from foundaticn..._............ .Distance to nearest lot line.............--- ❑ Numher of lines............... Length of each I:ne........-....-......... .._Width of trenc............... Type of filter material..... ....Depth of filter material......... . _._ ...Total length......................... ..........P Seepage Pit: Distar.e to nearest well i 0'j. _ Distance from foundation---la.._......Distance to nearest i ....-C jfi Number of pits .... „....._ Lnmg mater-al--- J2LC,r....c-,z. Diameter- .3.i- .. .__- Depa.,n-.-.30.1 .............� t Cesspool: Distance from nearest wcil--------. _ .-Distance from foundation_ _ ..... Lining material---- ❑ Size: Diameter_... . .. __. .. ._ .. Depth.. ..........._.......... ... .-. Liquid Capacity..........................gals. Privy: Distant_ from newest well. _ . ...... ................. -Distance from nearest building.. .... .-...----------.-.-.. \j ❑ Distance to nearest !ot Lne .. .. .. ..__. _....-_.. . .........._..._.-..-_.I..._. ------------ s Remodeling andjor repair;ng (describe):.. ............................................. .... .. .-------------•--- -- ------------_---------� ' ---•----•--------------------------------- -_..-...-......-...--.._....-.-_......__ ........... ...........................----................_....... ... .-...-.........- .---------..._.... ... ..............._....-..-.. -- --..__..---..._.....-.......-..-.-...... ..------...----•---------------------.....-.-......-_.........•-----......................I........... - ....... .........----- ...... - ------- ---- ...--- . - .. ............................ ............. . ... I hereby certify thif I have prepared this application and that the work will be done in accordance with San Joaquin Count; ordinances, State laws, and rules and reculations of the San Joaquin Local Health District. (Signed). -...0�� a "'^.. _- _ .... - Owner and/or Contractor l By:- ..-.. Psrr� �,wr. _ka.. ./stem �. . . ._ _..._ -.._Con. .'_%rr.. (Plot pian, showing size of iot, location of in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY % v ` �..�. DATE REVIEWFD BY. ._._.......__. BUILDING PERMIT ISSUED......__ .-.._ ..... .._ _ _. DATE.. ... . .._ .-. . Alterations and/or recommendations:_ _ _ ..... ....._ ........_...- _ ....... ._... ...._..-.-_...... ........ .. .. RNAL !NSPECTIOI) D"W SAN JOAQUIN LOCAL HEALTH DISTRI -* 130 South American Street 300 Weft Oak Street 132 Sycemore St'.0 814 North "C••Street SStockton, CeGfornia 1.odi, CaCfwc;a Manteca. Calif orn i. Tracy. California q .:f7eR6>�161�