20677 - Laserfiche WebLink

Home Browse Search

I ' FOR OFFICE SE: 3G --------- - --- - - � APPLICATION FOR SANITATION PERMIT Permit No. ---------- -------------------------------------- (Complete in Duplicate) __. __ _. -._.... This Permit Expires 9 Year From Date Issued 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. 549. : JOB ADDRESS AND LOCTIa ----- ----------------------- --- e = / Owner's Name-------- r' C. `------ r � ------ - -------------- ----- Phone- - -` #c2. �I fAddress--------------------------------------------- -- --- - -- --- -------------- - ----- '---------...----•--------------------------------------•--�-•--/-------------•---------------- Contractor's Name--------•-- Phvnef 6P �� ---------------- Installation will serve: Residencepa House ❑ Commercial E] E] ❑Trailer Court Motel f Other E]( Number of living units: ___ --_ Number of bedrooms _S-Number of baths J---- Lot size _-_62.Q_x------(._.!7� - Water Supply:= Public system 14 Community;system ❑ Private ❑ Depth to Water Table _ 7,0 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑' Sandy Loam ❑ . Clay Loam ❑ Clay ❑ Adobe �( Hardpan ❑ Previous Application Mader (If yes,date....................) No 0�1 New Construction: Yes ❑ Nox FHA/VA: Yes ❑ No ❑ p I TYPE OF INSTALLATION;IAND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest weli-----------------Distance from foundation-------------------Material---------------.----------._-_.-____.-_......... ❑�1GC5�IA7� No. of :compartments---------- --------- -----Size-------------------------------Liquid depth--------------_---------Capacity---------------------- Disposal ----- � Disposal Field: Distance from nearest well...M?------Distance from foundation__1� _'r____Distance to nearest lot line__S�_ -- -- t Number of lines---. _____ C1__.. Length of each line-----_ ! ___ Width of trench__._ Type of filter material_S +k...-k Depth,of filter material-----1Y------------Total length_-_---_-_fid--------------------- Seepage Pit: Distance to nearest ------Distance om undation___ 2-,_..__.Distanfe to nearest of line_, `5--_.___.._ Number of its._�L_ll___ Linin material_._ _ ______ P 9 Size: Diameter--- ----..._.Depth__2S— ----------------- Cesspool: Distance from nearest well-----------------Distance from foundation.-------------------Lining material_.__.-..-_.-________._________. ❑ Size: Diameter------------------------------------Depth------------------------------ ----- -------------Liquid Capacity- ---------- gals. Privy: Distance from nearest well-------------------------------------------------Distance from nearest building---------.__-_---_----------..-..----... ❑ Distance to nearest lot line------------------- --------------------------------------------------- •------------------------------------------------------------------- :3 I Remodeling and/or repaiein describe :__ ____ f 9 (describe) -- ---•--------------------•-- --------- ---------------•----- - ------ ---------------•---------------------------- ------•------- ---------------------------------------------------------------- ----------------------------------------------------------------------------- I --------------------------------------------------------------=-----------------------------------------------•-------------------------- t I hereby certify that Ihave pr ar d this application and that the work w�be done in accordance with San Joaquin County, ordinances, State laws, and rules nd eguAofan Joaquin Local alth District. Si ned Owner and or Contractor9 )-------------------- ------`------- ----------------- ---- - - -------- { ) BY:----------------------------'-------------------------- � {Title} '{Plot plan, showing size of lot, location of sn to ells, buildings, etc., can be place on reverse side}. FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY----_- -___ DATE--------6-----1-_-f ._ ----- ----------------------------------- tREVIEWED BY---------------------:------------------------------------------------------------------------------- --- --- ---------- --------------------- ----- DATE----- ------------------------------------------------------ BUILDING ------------------------ BUILDING PERMIT ISSUED----------------------------------------------------------------------. ---------------------------- DATE.--------------------------- -- ------ - - Alterations and/or. recommendation ---- -L r k c Y �' G_— vC.� ---- t7l - --------------- `=`= Y �+-'- -- �`--- t T -�- � -•--f/` -£-=--�1. - /Il i------lf<----` _.fit 4-------4- ."--f- -- <_df furl - - --'`-"-- FINALPE TION BY'-------------------------------------------------- ------------- Date----- ------ ---- --------------- r a'�G / d 9"Nn.—CAL Jif d o�iSANJ JO HE TH DISTRICT 1601 E.Hazelton Ave.. I380o1Nessdak 5 reef 24 Sycamore Sir 205 West 91h Street Stockton,California". Lodi, California r' Manteca,Califo I Tracy,California