5483 - Laserfiche WebLink

Home Browse Search

APPLICATI-ON_—FOR SANITATION PERMIT Permit No- ------W..... e in Duplicate) -------4C-6 in P at Date Issued Ap Ii,C'alion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. �p This 60plication is made in compliance with:County Ord' a ce No. 5749. -------------------- -------------------------------------------------- .............. JOB ADDRESS AND LOCATION. .: - !--- ne -so,q I Phone Owner's Name--------- AA Address f - ------ r . Contractor's Name--_:--------- -- ----------------------------------------- -- -- Phone_ Installation will serve: Residence Apartment House E] Commercial El Trailer Court ❑ Motel El Other El Number of living units: __-/_ Number of bedrooms -------- Number of baths -------- Lot size ----------------- Water Supply: -Public system PT Community system E] Private E] Depth to Water Table ft. Character.of soil to a depth of.3 feet: Sand FI Gravel 0 Sandy Loam El Clay Loam 0 Clay 0 Adobe Hardpan XPrevious Application Made- Ye's E] NoNew Construction: Yes Nok TYPE OF INSTALLATION;IAND SPECIFICATIONS: '(No septic tank or Cesspool peirmitted if 611C sewer is available within 200 feet.) a--res+,Y6111YAO---------Distance from fo tionJo-----------Mater ------------ ------------------------------ Septic Tank: Dis'fance' 'from'n gl, 50a _i. ........:Size_..0 .. - -----4 Liquid dep�h---9Z.-'r........... _j No',of:-'comparfr Z -ICapacity------ _10-------- nce from foundation---;1_0---------Distance to nearest lot line_____e-------- Dista Disposal Field: Distance from neareif we. Width of trench.---,3-0'"-------------------- r Numbe'r: of lines-------I' Length of eaEh'IinE'___j74*------------------ x V a, . ��—42------------------------ _y 'Depth of filter material---_41?-"'-',-_-Total -length--"_- Type of filter r, U ---- 4!5�_ .D'stance to nearest lot line-------- Seepage P;1�` Di�tance ,to nearest is'f a nc I rest wel --- -------D I ndafion ---De' Z's--------------------- Size:-Diamefe'r____,3_3- pth-1 'Nijrn.bi�r*jof,pits_=/---7:- ------ Ini g mat( ---------- '�efrom nearest well______________;'Disfan c M • .7, e from foundation..-._.":_._.. ___- Lining material----------------------------------- Cesspool: /Distan --------gals. ❑ Size: biameter----- ------------------------Depth------------z------------------' -------------- ------Liquid Capacity---------- --------- --------------------- --- Privy:' Disfance' from nearest well------------------ ......Distance from nearest building--:----------------- --------------------- Distance to nearest lot i�ne�------------------------------------ ------- ---------------------------------------------------------------------------------------------- El - ------ -------------------------11----------- Remodeling and/or-repairing (describe):--------------_------------------------------------------------------------------------------------------ I A ---------------------- ------------------------------------------------------------------- ------------------------------------------------------- --------------------------------------------------------------------------- ----------------------------- -------------------------- -------------------------------- -----------------------------------I-----------I------------------------------------------------------------------------------------ t --—-— ---------------------------------------------------------------------------- W --------------------------------------------------- ------- ------------------------------------------------------------- --------------------- I he y c ify that I have prepared this application and that the work will be done in accordance with San Joaquin County State laws; nd..rulqc and regulations of the San Joaquin Local Health District. ordinanc rSfate laws,-p K)www,4nd�bt Contractor) (Signed)-- ------------ -- --------------------------------------------------------------- By:---------------------------------------------------------------- - -- ----- --------------------------------(Tifle)-`E (PI;t plan, showing size of lot, location of systejin relation to wells, 'buildings, etc:can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BYe--------------- ---------------- ----------------- ---------------- ------------—DATE ----- --------------------------------- :��----------- V-.�------------------------------------------------ --------------------- DATE----5�__------------------------------------------------ REVlEWD BY----------------------------------- ------------------- DATE---------- ------------------------------------------- BUILDING PERMIT ISSUED------------ --- ---------------------------------------------- kv ---------------------- ---------------------- R -------------- Alteratioaand/or redolf)nmendations:-----------------------------_-------------- _`------- -------- -------------------------------- -- --------------------- A.* ---------------- ------ -------------------------------------------------------------------------------------------------V------------------------I--------------- --------------------------------------------------)� ------------------------------------- ----------------------- ------------------------------- ------ ---------------------------- -------------------------------------- --------------------------------------------------------------I----------------------------------- --------------------------------------------------------------- -,7e-j le-WIWIl"e---------------- --- Date------------------------------------- ------------------------------ FINAL INSPECTION BY. _------ ------------- --------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-4-2M , ' Revised W-2100