Laserfiche WebLink
77-.2 71 <br />Permit No, <br />Date Issued <br /> <br />MAC 5JITILE 4.A5Co <br />^ APPLICATION FOR SANITATION PERMIT <br />(Complete in Trinket') <br /> <br />Thu Permit Expires 1 Year From <br /> <br />the work herein <br />ons: <br />APPLICATION ACCEPTED BY.. <br />BUILDING PERMIT ISSUED <br />ADDITIONAL COMMENTS <br />DATE - <br />DATE <br />(Draw existing and required addition on reverse side) <br />red this application and that the work will be done In accordance with Sass- Joaquin <br />and Rules and Regulations of the San Joaquin Local Health District. Homo owner or Rests. <br />following: <br />the _work for which this permit is issued, I shall not employ any person in such manner <br />on laws of California." <br /> Owner <br /> Title <br />I hereby certify that I h op <br />County Ordinances, Slat <br />sed agents signature cent <br />"I certify that in the Red ?no <br />as to-bean craublect to Work <br />Signed <br />By <br />Of other than ow <br />FOR DEPARTMENT_ USE ONLY <br />Final inspection by: <br />113•1 13 24 1-68 Rev. <br /> Date <br />SAN JOAQUIN LOCAL HEALTH DISTRICT 8117h 314 <br />Application is is hereby .• • e to the San Joaquin Local Health District for a perm <br />described. This °police onls made In compliance with County Ordinance No. 549 an sitting Rules a <br />JOB ADDRESSAOCATIe•N •;°L- CENSUS TRACT ..... . <br />Owner's Name <br />Address <br />Contractor's Name.. <br />Installation will $ <br />Number of living un <br />Water Supply: Public <br />Character of soil to <br /> Phone <br />City ....720t1e9- ('•€9 • <br />license # Phone <br />Commercial °Trailer Court 0 <br />••, <br />Lot Size • <br />Private 0 <br />nd 0 Silt 0 Ci 0 Peat 0 Sandy LOCIFYI 0 Clay Loam 0 <br />Ill Material If yea, type <br />ResidencegtApartment House <br />ppTT <br />oiled fOOMS rbage Grinder <br />• <br />(Plot plan, showing <br />NEW INSTALLATION: <br />PACKAGE TREAT <br />• <br />LEACHING LINE [ <br />t, location of system In <br />ptic tank or seepage pi • :rmitted if pu <br />PTIC TANK <br />Size <br />tY42, <br /> <br />pa..er-...:V-...*.olte.eviaterial <br />to rest: Well ..... Four: <br />F Lines Length of each line. ..74C / <br />Liquid Depth <br /> No. Compartments ‘9.— <br />/ Prop. Line ‘6-27 1/451 <br />Total Length ;V.-) 29 I <br />to wells, buildings, etc. must be placed on reverse side.) <br />Se 200 feet) <br />REPAIR/ADDITION (Prey. <br />Septic Tank (Specify R uir <br />Disposal Field (Sped R <br />SEEPAGE PIT [ <br />4.•* <br />isto <br />epth <br />ate <br />ista <br />• nit <br />• <br />... Type Filter Material <br />to nearest. Well Found": on-. <br />---Diterreter <br />Depth filter Material <br />Table Depth Rock Size <br />to nearest: Well Foundation <br />tier: Permit # Date <br />mental <br />uirements) <br />No 09 <br /> Prop. tin....._.._.._.._.:'