SU0000641 - Laserfiche WebLink

Home Browse Search

0M13 rry. '6d�u. �•{G:'h'.�,`/�Y�nP -yy_. f`T1 3� �, '�� Yom.:a nxa, '�'. ,. � .� .hcrw ,.r.».n.�7rYq�a• .4x3:'- � .. 5:•._'� FOR OFFICE USE, « FOR'OFFICE APPLICATION FOR "SANITATION PERMIT GG (Complete In Trlpfleato) �:. Permit No...7 .: 7 .............................................. r � - q Date Issued....1gn1:?Z ....... This Pvmlt iExpirei 1`Year from Date issued t -....-.--................. -.�'k . r. _ia � .aMx^Y; Application is hereby made to the San Joaquin La61':Heaith,DisMct for d rmit to•construct and.Install the-work herein described- :A!,� This appticr:tion is made in compliance with County Ordinance Na154 a„d isting.Rul red Regulations' = j{ Y t A w � - J09 ADDRESS/LOCATI D'' ... ....•.��-... ..:�I :...CENSUS TRACT..........: °............... � J. Owner's Name.... ... ............................... .........Phone............:.. Address............. v {� - . city..................... .... ..... ... Contractor's Name:. ...License #.,sort o e � T, r Installation will serve; IR' idence Apartment House Commercial TrallerW P ❑ ❑ Court ❑ Motel ❑ Other_-..............L.................... w Number of living units:_............Number of bedrooms...-...Garbage Grinder............Lot Size..../...... :-. ..; .- J* t . `' Water Supply. Public System and name-. ..--.-. .-......-. Private [3 ` r Character of soil to a depth of 3 feet: Sand Silt Clay Peat 0 Sandy loom Clay Loam Hardpan ❑ Adobe❑ Fill Material - ....If yes.type................................ iA. (Plot plan, showing size of lot, location of system in relation to wells, buildings,etc.must be placed on reverse side:) NEW INSTALLATION: (No septic tank or seepage it ermitted if public sewer is available withi`120dfDe,tfi....!E}.-..•••---••••� _ P Pa9 P P PACKAGE TREATMENT [ } SEPTIC LANK I Size ..T..X i/` I q P , No, Compartments..... - PCapacity.1l!-00....:Type... ....,. ......Material.. -( I r Distance to nearest: Weil.-...... 49 :..... .... :.......Foundation.-.-- Prop. Line................. h LEACHING LINE [ ] No, of Lines Length of each line.:.... ........°=--•-Total length 1.. Q.......--••--•-••••• .; D' Box...r Typo Filter Mater! . Depth Filter Material.....-�. .•.�..................... .......... t Distance to nearest,Well...:............ oundatian..,..... ..-....-._.........Property Lina......-............-.-......... SEEPAGE PIT ( ] Depth.. .f..67 Diameter.__. Number. . .0.........I............ Rock Filled Yes j� No� s � i Water Table Depth...........................-... ,.......................Rock Site....-.f. . ...-........_........... t 1* - Distance to nearost, well.,.............. ..__....Foundation......-......... .: Prop. Line....:................... .. p. 3 a 1 REPAIR/ADDITION(Prev.Sanitation Permittlt................................... .... ..........Date. } # r Septic Tank(Specify Requirements). .. . .. ..............................--11. ........ .................... ................ ...... ............. .......... . .......... Disposal Field (Specify Requirements) ........................ •....................... -I ................. .... ..............................-.-....... -,-........;.''..................... ................ P •_..-.... ............................. .. .... . ...................................................................................... . ........................... ...... s (Draw existing and required addition on reverse side) f t hereby certify that I have prepared this application and that the work will be done In accordance with San Joaquin County F Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District, home owner or licensed agents signature certifies the followingt "1 comfy that In the perfatmance of the work for which this permit Is issued, I shall net employ any person in such manner as N, to become subject to Workman's Compensation laws of CQllfernlq." Signed...... .. . - . -......... Owner y... By...,..•...... .-� (j's. Tit a ............ .......... ..., ( other than owne►1 R DBP TENT U3ONLY — .. ..�.. APPLICATION ACCEPTED BY....-:. .- r ... . /tSw+t. .... ....:...................... .DATE - DIVISION OF LAND NUMBER- ..... .............. ........ .....•..,.,. DATE ,... � ADDITIONAL COMMENTS , ..... . .... ......................,....... ' ,... �.. ., .. .. .......... ..,.. ... . ..- ...... ..- p. on by' dj.. ......... . Date A 15 Final Ins . f.r.e.s�ti. es rev,she se SAN JO IN LOCAL HEALTH DISTRICT