SR0081884 SSNL - Laserfiche WebLink

Home Browse Search

FOR OFFI E USE: permit No. b a�1 ,G��• ...._ .. � .` APPLICATION FOR SANITATION PERMIT . _. . pDuplicate) -••"---- --- ---- ---- -- ----- (Complete in -" •- Date Issued .............._ --• •••= This Permit Expires fres 1 Year From Date Issued ........................... is hereby made to the San Joaquin Local Health Distrriic f o a permit to construct and install tfie work herein described. Application Y This application is made in compliance with County Ordinance JOB ADDRESS AND LOCATION.ZR-1257----/�•-- Phone y-�• `11t�' .: + �. ! _ .f�f�R�ll�.1Y.. ------•--•.._...---- - ..Owner's Name •Q� f .. - ....................... .-- ...-----•-•-•--•-- -••-•....-_ C 5� +< ................ ..... Address-_ --•-------- _ ........... hone.. rP�l?/,Y S7�`IS�S._...�.�V�'....... Other Contractors Name..... -��' "' ! Trailer Court ❑ Motel ❑ ❑ ` Apartment House ❑ Commercial ❑ O Installation will serve: ,Residence f-L Lot size .... w '�' """'" t Number of baths "-•y Number of living units: Number of bedrooms - th To Water Table - ft• Community system Q Private �DeP Adobe 1�Hardpan❑ •Water Supply: Public system ❑ Clay Loam[►Clay❑ Gravel Sand Loam❑ Y FHA/VA Yes❑ No❑ Y • Character of soil to a depth of 3 feet: Sand❑ ❑ New Construction: Yes ❑ No Previous Application Made: ilf yes,date............:.......) No t TYPE OF INSTALLATION AND SPECIFICATIONS: y (No septic}aakjor cesspool permitted if public sewer Distance from fouhda?oOna_fe®t.� ••• Material.-2.......... .................-........... Capacity Septic 9�k Distance from nearest well..---_•-•- Li uid depth---•----•..-- _....._. .....•......--"-•--•Size----------------- q ! 1 No. of compartments............... Width of trench Disposal • osal Fiel • , Distance from nearest well....�.J`�-�-----Distance from foundation..•.�5---•--•--Distance to nearest lot ins.•-•--- =•••••-- Disp Length of each line-------. ;; Number of lines__.._...__.�. 9 • !C "__...De--Depth of filter materlal__.I�•••.._.....Total length._-•------ �t - ,,,f Type of filter material ---- p Sj 6? `_--•Distance to nearest lot line-i---- a^"' ' Size: Diameter p Seepage Pit:-li: •.9 - . Depth , Distance to nearest weli__-I�:!•••"••.Distance from foundation A) Numbea-of pits-•--.. --•-...._.._Lining material `'X ` 'd Capacity gals. ` Cesspool: Distance from nearest well.................Distance from foundation Lining matperia :--•---: .. _Liqui ❑ Size: Diameter--""-_...-------•-----------••------•-Death----------------------------- ---- I ----------------------- Privy: - ._.... Distance from nearest well---------------•"--••---••--•-•---"""'"`;'-Distance from nearest building ❑ Distance to nearest lot line------------------ ______-----•-.-- describe ��-0 Remodeling and/or repairing t }�-•---• .............................•--•..__......_....---•-----•--•..------•--•-•---.....----••-•-----•---••-•-.. ...-----•------•..._......_ ----•• .............. .................................... ----•--••-•-----••-----......_......_._.........-----•................................... riat •- •ll b ...--ne- ••. 1 hereby certif that I have prepared this application and the} the work will be dans is accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. ... . ----_. ..._ (Owner and/or Contractor{ ---•-------------••- . ........................... (Signed] ...•..__. _ ltl ... e . llay,showing size of lot, location of system in relation to wells, buildings„etc., can be placed on reverse side}. {Pot p 1 FOR DEPARTMENT USE ONLY .......... DATE-0----- --------...... t APPLICATDATE..............•-----•------------------------------------------------------------------ ION ACCEPTED BY.._.C._............... ..- REVIEWED BY------ --.-•--------------•--.........----•- ... ... BUILDING PERMIT ISSUED. ................ r � / '� .. a. � Alterations and4or recommen ations:.... �..•. y ............I............- .---•------- ---- ..........................-... 4 r Date.....}_Z..-....1.b....-...2—.._...._...:._..._...:. .. FINAL INSPECTION BY:---- .---...--"--•.. .,- • ` SAN JOAQUIN LOCAL HEALTH DISTRICT 205 Weil 9th Street apo West Oak Street 144 Sycamore Street Tracy,California 130 South American Street Manteca,CaliFornla Stockton,Callfornla Lodi,Catifornia ES 9 REVISED 8-59 ZM 5.62 ATLAS