SU0012496 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: a o APPLICATION- FOR SANITATION PERMIT Permit No. ...11�S/a.6_. /3 y.f---------------- ------ //._ ----- � _. f.`-s-"_--- :'.ia.._ (Completen Duplicate) Date Issued This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. S49. / �� JOB ADDRESS AND LOC TION...•--- ��.�,_.1... 000. � 1 /�" Sd•� Owner'-s Name.. •--- / 44117t1�11Pe ----- T/lOif'llRS Phone.977� ,5�. Address•----------•-------_-------- 4.--••--... t9�d ..._.LGA-- •...... ......... Contractor's Name--------- l�- Phone - -'0-- 7 fes--- Installation will serve: Residence [Apartment House ❑ Commercial ❑ Trailer Court ❑ Mootrrel ❑ Other ❑ Number of living units: ---/__ Number of bedrooms __-3 Number of baths __a`Lct size __._-/`TC./�,�. -.G.49--,. Water Supply: Public system ❑ Community system ❑ Private [Depth to Water Table ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam E] Clay Loam E3--Clay [j Adobe ❑ Hardpan ❑ Previous Application Made: (If yes,date........_..........) No P11", New'Construction: Yes ❑ No SHA/VA: Yes ❑ No [:J— TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distancefo .. - from nearest well_________________Distance from undation._._________. . .Material..... -...__._-...._.---.....-___...__ ---------- ❑ No. of compartments..... .........1'........_.Size--------- ------Liquid depth--- -- --- ---------Capacity........---............ Disposal Field: Distance from nearest well.................Distance from foundation--------..----------Distance to nearest lot line_____--.-_.___.-. ❑ Number of lines---------....... .................Length of each line..... _-- ------------ Width of trench..------------.--------------------. Type of filter material ........................Depth of filter mate-ial-------__..._..._._._..Total length.............._._:_.__.__________-___----- ,`1 1 a— �� / 1� � ,�}}Q __..__.Distance to nearest lot line--ip..._.... Seep t: Distance to nearest we11�.4�_.__--__..._Distance fr foundation._. ..__.___ g S E/ Size: Diameter S3-a i � Number of pits.......... ..........Linin material, . . ._...-------Depth.--..;2-3_......------------- Cesspool: Distance from nearest well.._.............Distance from foundation---------- ...Lining material---------- .----------- --------------- ❑ S-.ze: Diameter................. ---•-•--Depth....... •--- ------__------------ .......... Liquid Capacity------•-----. ------------gals. Privy: Distance from nearest well------_------__---------.----------.-------------Distance from nearest•builyding_................-----------------..... Q , -- -- --------- ....................... Distance to nearest lo- line_ _ ----_-------------••---•------- ----------------- ------------ ------------ _..---... All- Remodeling and/or repairing {describe):_--._.. ... _ � �---- --- ------ -- - - __ _.... - -------------- --••••.........._• -- :'---------------------••-------'................._...-: ------------------------------------------------------------------------------------•--- --------------------------•-•--•--_------ ------------------. ---.._..._.........o.--..... I hereby certify th I have prepared this application and that the work will be done in accordance with San Joaquin County.. f ordinances, State laws an rules and regulations of the San Joaquin Local Health District. ;�� �� 1 9 (Signed) .C�.!?'.--. '�f/- --------------------- -------------•-------- r or.Contrector g )...................V- .. ----• -- .----f Title .. By:------------------ ----- �'F - -- -� ) f---...._._...- (Plot plan, showing sizeo lot, location of sy em in rto wells, buildings, etc., can be placed on reverse side).' FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-_---------------- -/_-----•-•--------------------------------- ------------- DATE.........�-�� .- __ . REVIEWEDBY ----------------------------- ......--- DATE............................ BUILDING PERMIT ISSUED----------- - - .-------- - -------------- - ------------ ---...--. . -._-......... Alterations and/or recommendations:----.._ ��/6>"- - - G' � �r �s��L�.J - -- �� / /__ �,x�_Z>"'` .y��'cc9. ..�..n� f_s�J-•�cc� _rt�.�-.:?!' -•---------- ---- - ......... FINAL INSPECTION BY:. ... --------------- --------- - Date_....._lr..__�. / J JOA ` OCAL HEALTH DIS STRICT ' r 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 91h Street Stockton,California Lodi,California,J Manteca,California CV Tracy,California