Laserfiche WebLink
Iwurlrww� r rgrrr3 <br /> APPLICATION M HEREBY MADE TO THE SAN JOAQUIN COUNTY FOR A PERMIT TO CONSTRUCT ANOIOR INSTALL THE WORK DEBCIBBFD. THIS APPLICATION IS MADE IN COMPLIANCE WITH BAN <br /> ' JOAMIN COLINTY DEVELOPMMIEFM/TITLL C <br /> H <br /> APTER <br /> S- <br /> 1 110.3 AND THE STANDARDS OF SAN JOAQUIN COUNTY RINJC HEALTH 1BF�]1VILEPS,ENVIRDNEENTAL HEALTH DFASKIN- <br /> JOB ADDRUMS APNI C^!I �l' JT 1'WV7"f WLR CI <br /> CITY��„ '�•n�� /�(�'/, LOf BI�ZF��7�(/�CE <br /> OWNER'S NAME_�� \//L''���Vl�11Lr� L. e1r�" ADDRESS �,�r L. 1 ICO P�IE\/E,rl"Y� "J3M BION( I/�J <br /> ' CONTRACTOR_ l.J w1 ( ADDRESS UCI RHONE <br /> BUB CONTRACTOR_ ADDRESS LIC# PHONE <br /> TYPE OF 90POC WORK: NEW INSTALLATION ❑ REPAIOADDNION ❑ DEATRUCTION <br /> INC SEPTIC SYSTEM I£MIARTED if RIBNC SEWER IS AVAILABLE WITHIN 200 FEET OF BUILDING.) MMIC TFATRI l 1110 W MANY <br /> APMlstlon I <br /> INETALLATION WILL SERVE: RESIDE,VCE❑ COMMERCIAL 13 OTHER 13 NUMBER DF LP Rxa UNITS:_ NUMBER OF BEDROOMS: NIIMEER OF EAPLOYEEI: <br /> CHARACTER OF SOIL TO A DEPTH OF J FELT: PRISUMP SOIL CHARACTER: WATER TABLE DEPTH <br /> FEPTIC TANKU FASO TRAP ❑TYPEMFG CAPACITY MO.COMPARTMENTS <br /> MG TREATMENT RANT❑ DISTANCE TO NEAREST: WELL FOUNDATION rflcm TY ONE <br /> ' UFT STATION❑ SIZk TYPE OF PUMP SAND OIL SEPARATOR ENCLOSW SYSTEM$ <br /> LEACHING NNE ❑ NO.B LENGTH OF NINES DISTANCE TO NEAREST:WELLFOUNDATION PROPERTY UNE <br /> FILTER BED ❑WIDTH LENGTH DEPTH DISTANCE TO NEJJEST:WELLFOUNDATION PROPERTY UNE rV�r <br /> MOUNDED ❑MOTH LENGTH__DEPTH DISTANCE TO NEAREST:WELLFOUNDATION PROPEETY UNE V <br /> ' $MADE PITS ❑DEPTH SIZE=—DENUMBER DISTANCE TO NEAREST:WELL -FOUNDATION PROPEATY UNE <br /> O ❑WI <br /> SUMO LENGTH PTH DSTAA'CE TO NEAREST:WELL FOUNDATION PROPERTY UNE <br /> DISPOSAL PONOS WIDTH LENGTH__DEPTN DISTANCE TO NEAREST:WELL_FOUNDATION PROPERTY UNE G <br /> ' I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DOME NF ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES MO STATE LAWS,AND RULES t <br /> AND REGULATIONS OF THE SAN JOAQUIN COUNTY.HOME OWNER OR LICENSED AGENT'S SIGNATURE CEEEEIE6 THE FOLLOWING:'I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH <br /> THIS PERMIT IS ISSUED.I SHALL NOT EMPLOY ANY PERSON IN SUCH A MANNER AS TO BECOME BUEJECT M WORKMAN 8 COMPENSATION LAWS OF CAUMP"A.' CONIIIACTOA'S HIRING OR <br /> SUB-CONTRACTING SIGNATURE CERTIFIES THE FOLLOWING:'I CERTIFY TUT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL EMPLOY PERSONS SRRJECT TO <br /> WORKMAN'S COMPENSATION LAWS OF CALIFORNIA." THE' AMrNCARITTAllL 7,CALL 14 HOURS IN ADVANCE PON ALI REQUIRED INSSPPE�CTIONS. COMPLETE DMWINO BELLOW. / _EGNEOX �-T ` YYVWB �d� TITLE: DATE: <br /> P I <br /> ` ROT PLAN(DRAW To SCALE]SCALE 1�4D_•LC <br /> ' 1. NAMES OF STREETS OR ROADS NEAREST TO OR SOUNDING THE PRDPLRTY. A. LOCATION OF HOUSE SEWAGE DISPOSAL SYSTEM OR PROMISED <br /> t. OURINE OF THE PROPERTY,WITH DIMENSIONS AND NORTH DIRECTION. EXPANSION DF SEWAGE DISPOSAL SYSTEMS. <br /> D. DIMENSIONED OUTLINES AND LOCATION OF ALL EXISTING AND PROPOSED STRUCTURES, S. LOCATION CF WELLS WITHIN RADIUS OF ONE HUNDRED FIFTY FT.ON <br /> INCLUDING COVERED AREAS SUCH AS PATIOS,DMVEWAY6,AND WALKS. THE pgOPERTY OR ADJOINING PROPOTTV. <br /> O <br /> hl <br /> :�FLYrt�iEN"? � <br /> I <br /> -PI $ <br /> ' <br /> JU1.. 2 7 1995 <br /> AN <br /> t16LIC N£ALTr �G� <br /> SERV$ - <br /> 23q l <br /> 44 ZA51 5,. M Li VLA" !V ort <br /> .._ <br /> FOR DEPARTMENT USE ONLY -I <br /> APPUCATION ACCEPTED B`. DATE: l AREA: r <br /> TANK,PR OR SUMP INE)YCTION BY DATE l I FINAL WBPECTON BY DATE l I <br /> ADDITIONAL COMMENTS <br /> ACCOUNTI'tl0 ONLY_ NDA FAC/ <br />