SU0004528 SSNL - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ?LICATION FOR SANITATION PL .IT Permit No. ---------------------- ------ - - -_-_-------- / ---- ------- -_--- (Complete in Duplicate) Date Issued This Permit Expires 1 Year From Date Issued ______. ._1tr_ _. •. Application is hereby made to the San Joaquin Local Health District for a permit toconstruct and i stst 11 the herein escrbed. This application is made in compliance with County Ordinance No. 549. %�6 � 9 � r v , /�' 1D i JOB ADDRESS AND LO ATION-----------------Rt-:.,!_.-- -aax- Ae.......a 1 �'l�-/.(�1-W 1 �1 /c �F c�� Owner's Name-----------------�_d--�1_ _-Y14r �'`(�' -v1-e-�--rtL - ------------ ------------------------- ------------------------ Phone_ -P�• Address-------•----......R_t -�------- (��r`,•-----------------------------------------------------•---•----------------------------------- Contractor's Name--------•-----6 e-9 --------•-•-- � ---------------- Phone..----.-_-----------_---------- Installation will serve: Residence ❑ Apartment House ❑ Commer ial Trailer Court ❑ Motel. ❑ Other ❑ Number of living units: -------- Number of bedrooms -------- Number of baths -------- Lot size ---------/.* --- ----a-C- --- --- - ------------ Water Supply: Public system ❑ Community system ❑ Private Depth to Water Table .15,67 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe qKHardpan ❑ Previous Application Made: (If yes,date....................) No RNew Construction: Yes ❑ No E] FHA/VA: Yes ❑ No [r TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public�spwer is available within 200 felt.) h ' N Septic k: Distance from nearest w I_.5-Vxopistan romf u tion I®-x1�;_%.Materia _ -.-Cd.'/._ _!_______ ___ _______ No. of compartments.__.________ ______Size_ _______�-4____Liquid d pth---- /--_.Capacity-___ C�._ 2 / — — Disposal field: Distance from nearest w6I150Size-- from foundation.//� fAC4t. Tlt, L!__ Distance to;nearest lot I�,e__�-h1�' Number of lines____._,_.I________ ______ _ _Length of each line-------1.00�__�/___.Width of tfench.____a_._'.__-___-_.t Type of filter material_ 7 _� Depth of filter material_-__.-_f.�.-_____._Total length-----------------/Ol9____________-__ Seepage Pit: Distance to nearest well_._._/___-----------_...Distance from foundation....................Distance to nearest.lot line____-__.-_______- i ❑ Number of pits______________________Lining material------------__---------Size: Diameter---------..............Depth_._-._.:_.____________._._ ....... Cesspool: Distance from nearest well----------------- fro'rri foundation-----------.--------Lining material _________----------__-____-_____-___ } ❑ Size: Diameter--------------------------- ----------Depth-------------------------------- ------------------Liquid Capacity------ -------gals. J Privy: Distance from nearest well ___-_-____.__- --------------;___ ---------:_Distance from nearest building__________________________________________ ❑ Distance to nearest lot line-------_-------- ------------ ------------------------------------------------------------------------------------------------------- f Remodeling and/or repairing (describe):__-_ ___ . / . - 4 -------------------------------------------------------------------------------------------=-------------------•----•------------•--------------------------.--------------------------------------•-- ------ _ -•------- ----------------------- ----=----------------------------------------- ------------------------------------------------------------------•--------•---------------------------------- . ---- � I hereby certify that 1 have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State law and rules and reg lationsof the San Joaquin Local Health District. (Signed)----- -- ---------- --------------------- ------------------------------------------------ --------(Owner and/or Contractor) 4 By:------------------------------------------------------------- ;------ :.-------------------------------------------(Title)--------------------------------------..---....- -------------- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY L APPLICATION ACCEPTED BY--------------------•----- -- -------- ----------------- ---------------A� --- ---- -&DATE-------- f� --- - --------- - REVIEWEDBY--------------------------------------------- ---------------------------------------/--_---------- DATE---------------------------------- ----------_-------- BUILDING PERMIT ISSUED - ---- -- ------ - -- ------------ DAT -- ---------Z-; Alterations and/or recommendations:_.._.__. _�� jy._._.�(1 �1 �( --- (/ l -• ctk - • Vit./--- ti. rr{--- - -- --- ------- - � - 1 1 -•--------- ------------------------------•----------•------•------------------------------•----- - ------------------------------------------------------------ ---------- --- Z L � FINALINSPECTION BY----- ............. ------ ------------------------------------ Date---------------------------------------------------------------- ............... SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Ha:ellon Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California CS 9 REVISED 8-59 3M 3•'63 F.P.CD.