Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> S���/��s���`����� 1���o ��'�����'m���� <br /> NON-REFUNDABLE PERMIT,,- CALL(209)953-7697 FOR INSPECTIONS ExPIRES I YEAR FROM DATE ISSUED <br /> la CITY/zIP <br /> JOB ADDRESS <br /> OWNERNAM PHONE <br /> OWNER ADDRESS <br /> CONTRACTOR M PHONE <br /> WATER TABLE DEPTH: o �a�mwxIC^ /wmn ^nn~. o"orvinm°- <br /> BUILDING PERMIT LAND USE APPLICATION# <br /> I DES' <br /> TYPE OF WORK: L; NEW INSTALLATION L40- REPAIRIADDITION <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> D STIR CTI N <br /> INSTALLATION WILL SERVE: tewSIDENCE 0 COMMERCIAL E, OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDRooms:.-___a_..— NUMBER OF Ew�A�: <br /> DISTANCE To NEAREST: WELL ft FOUNDATION_............ ft PROPERTY LINE <br /> El UFTSTATION SIZE TYPE OF PUMP------Q PKG TX PLANT U SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> __�________-_______ <br /> __- Lf Or � <br /> 0~�s^umuwso c LEACHING cx^mos �N� u � <br /> �or " _�.~__-___- <br /> DISTANCE n`NEAREST WELL Sn` it FOmwu^now _ !__�o PROPERTY LINE_�� ___-« <br /> n �s*ox � os�m u <br /> El FILTER BED w.Dm __--______� <br /> DISTANCE ruNEAREST it FOUNDATION PROPERTY LINE ____-« <br /> o Moumoso wmm _____'n LENGTH ................ ospm » <br /> DISTANCE roNEAREST WELL_ .............-_. it FOUNDATION it PROPERTY LINE ______ft <br /> o SUMPS WIDTH____ft LENGTH u DEPTH « <br /> DISTANCE/^NEAREST wsu__-___- it nmwmATmw PROPERTY um,________-« <br /> L3 DISPOSAL PONDS WIDTHu LEwaxx o osPTo_ ft <br /> DISTANCE`aNEAREST WELL u FOUNDATION ft ,purs��u/ws________-o <br /> ft <br /> - EEPAGE PITS -_ it <br /> DISTANCE To NEAREST WELL--- ft FOUNDATION it P80PERTY LINE. <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORKWILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM 24 HOW"DVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 090-KI-1697 <br /> SIGNED TITLE 4�61(1 DATE <br /> R-7 <br /> DEPARTMENT'USE ONLY <br /> App ion Accept d Date__:2t <br /> Final Inspection By Date Ljj� <br /> I_L_f- SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 actor: vaV.-I Ir <br /> Code INFO BY Remitted Service Requ <br /> mm owmWASTEWATER SYSTEM PERMIT <br /> w,w`2 <br /> ��� <br />