SU0012521 - Laserfiche WebLink

Home Browse Search

--—tOR OFFICE USE: .-r -------------------------------------------------------- APPLICATION FOR SANITATION PERMIT Permit No. .� 3. . ............ ------------- ......................... (Complete in Duplicate) / This Permit Expires 1 Year From Date Issued L@Date Issued ...._/...I Z(o Application is hereby-made to the San Joaquin Local Healfh District for a permit to construct and install the work herein described. This application is made in corn Ince with County Ordinance No. 549. �Anj'-�.G/9 JOB ADDRESS AND I0fAT ._� . 1I. _._. .__. t __.___ _-_ Owner's Name............--�--•Q�-�------- --•-alm.>��7.�}:�.----..................... .........••------••-•---......---'------•----Phone.................................. 3 Address............ - - - Contractor's Name-•-:----0.W. ............. -••----••--••-•---•--••.................................I--........................... I'llione................................... Installation will serve: Residence Apartment House 0�, �Commercial E] Trailer Court ❑ Motel,F] Other [31 _ _ Number of living units: ._-.�_ Numberyof bedrooms :_Number of baths ./.-_ Lot size .... P.... .'!�4rR. e-.��.......: Water Supply: Public system ❑ Community system ❑ Private 2r"6epth To Water Table ft. Character of soil to a depth of 3 feet:• Sand Gravel ❑ Sandy Loam i;--clay Loam Clay ❑ Adobe❑ Hardpan Ce Previous Application Made: (if yes,d ate..._..~.--.......-} 'No p 'New `onstru t;o� Yes o ] FHA/VA: Yes,��No [ (�'� TYPE, OF INSTALLATION AND SPECIFICATIONS: �- (No septic tank or cesspool permitted_if public sewer is available within 200 feet.} Septic Tank: Distance from nearest well��Distance from foundation....................Material.............................................. Tl/J No. of compartm ntsi-"„'��..........-Size--- a --------Liquid depth..................... Capacity....."._.`..? y Disposal Field: # Distance from nearest)j`''ell-_-1W._.1 Distance from foundation---.-(Q____-_-_-Distance to nearest lot line..5- EF ZI ��Qj�Tl� ' Number of fines.___�11.___. YLen th of each line_....___ .. .... " I ••-•-- 9 - Width of trench ._. ��- T Z�of'filtermaterlah:_ De th.of,filter,material_-_-/Z Total len th--_-_._-- ,5r.__._.............J Seepage Pit: Distance to,nearest-well__------ .-----Distance from foundation-------__-----------Distance to nearest lot ❑ Number of.pits_....�""T` ..-.Liningmaterial_._._.._.....r}_.__..Size:,Diartleter Depth.._....___.__._..__. _...._.__. a-rlI I Y._ Ste' Cesspool: Distance from nearest well...._____._._...•Distance from foundation--------------------Lining material........ tj Size: Diameter, -- -------------------De th._--_........_......-- ----- ------------------Li uid Ca aci dli ❑ r P q P tY ----------------------9 , Privy: Distance from nearest-well............-...............................___Distance from nearest building---------------------___-_-___.._._._. ❑ Distance to nearest lot' line----••-----------............ -•---- ----------•--------------------- t Remodeling and/or repairing (describe):._`. -f�-_�3--------------5-67--EW------1AVV.—it A.4Z-D._....W___114CaT_7^_....... _�.r� K{......Ars...._.._ .f-��. nt •-- - ----------------------....-------...........................-.............. ...............................................................------- .....---.•-------------------- r*-F.K..04.......................................................................... 1 i l I hereby certify that I have prepared'this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, a d ru and'regulatio J of the San Joaquin Local Health District. I LL (Signed)------- ------.........T_-'._-- _ _-- - -.-----•- - ....--.-.Owner end or Contractor By: �---------- ........ ...... ..... ------------------------------------------------------------------------(rile)-.---._... ._.. .. ----- ............ .. . . (Piot plan, showiig size of loft, location o�`.T+emlin relation� to wells, buildings, etc., can be placed on reverse side): ( 'FOR DEPARTMENT USE ONLY ,J ?; APPLICATION ACCEPTED BY--- f ' j``' ------•---•-------• -- 1.._......... ---•------ DATE'-7'--- ---- 23/ --------------- REVIEWEDBY... ................................. ------ .................I........................................................ DATE_`'---------- -...................._-------------- ) BUILDING PERMIT-ISSUED.---=_" _ -------- .... -DATE.----.mW L— ----=------------ - i Alterations and/or recommend'ations:---------•..................................... = -"----•----....................._............-........................-......---------------- .................................................................._..................................................................................................................- 1................ ....... ..........................•.... ............ — ----------------------------------------------------------------------- .. l�Q- _.... .... Date_... _. ... -------- FINAL INSP N BY: f . -SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 Wett Oak SaNt 124 sycamore Street 205 West 9th Street Stockton,California ' Lodi,California Manteca,California ?racy,California ES 9 REVISED 8.59 2M 5-62 ATLAS ;