19763 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: T -- --------------- - ------------ APPLICATION FOR SANITATION PERMIT Permit No. ./- �-•-- ----------------- ------ ------ } (Compete"in Duplicate) Date issued - ---------------------------------------------- -- This Permit Expires 1 Year From Date Issue Application is hereby made to the San Joaquin Local Health-District for-a permit to'roristruct and in 11 the work h e's r described. This application is made in compliance with•County Ordinance No. 549: /� - a ,V� G�'. `� ,� ez_// ------------------------------------- -------------------------•--------------------------- JOB ADDRESS AND LOCATION Xl--�/�� - f r� Phone------------------------------------ Owner's Name---------- / ------ -- Address-------------------- ----"- .. Qter` ,-----------�7-m,� ,✓�-c �Y Contractor's Name---------------- Motel El Other ❑ Installation will serve: Residence Apartment House ❑ Commercial E] Trailer Court ❑ 7--- ------------------ Number of living units: __�_' Number of bedrooms __� Numberfofbaths„ ..._ /_-__,Lot size._” _ _- _" a rQ-ft. Water,Supply: Public system of Community system ❑ Private Depth to Water Table ti d " r f Adobe Hardpan ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ _Sandy Loam ❑ Clay Loam ❑ Clay ❑ ❑ #` if New Construction: Yes ❑ No [3—'FHA/VA: Yes ❑ No 3— Previous Application Made: (If,,gels,date._-"----------- -- ) No d L TYPE OF INSTALLATION AND SPECIFICATIONS: ` (No septic tank or cesspool permitted if public sewer is available within 200 feet.) " 1 if Septic Tank: Distance from Barest well___---"._._"____Distance from foundatiLn_�I�__�e th .Materia4 = __Capacity____________----------- A. ❑ No_ of comparments .------ Size q p. # t Disposal Field: �Distance�fromrnearestwell____._.-."- "."-Distance from foundation___________________Distance to nearest lot line___________.____. Number=of lines__--- ---- ---------------Length of each line------------------------ Width of trench-------------,---------------- ❑ y r.. F Type of filter material_'----- ---------------Depth of filter material:._---:--= Total length______ _-=-------------- i r s / s• 101Y . Seepage if: Distance to nearest welly/ ------Distance fro fou,ndation----�"_�__-__.Distance to nearest lot line_____--.-"__-_-_ Number of pts._ -".-!._- ---Lining material--- Size: Diameter'_- "ti'4rr ------Depth--.-_----- ----- I!# amaterial 4 . Cesspool: Distance from 'nearest well_________________Distance from foundation"_--_"--._- -_"_--.Lining material___-."-___--__--___--____-__________ ,i _Li uid Capacify-_ gals. ❑ Size: Diameter-•-:- --------°'= - - -----------Depth-------- q €� Y -d.44*- r' ' _."----_Distance from nearest building__"--_ ----__---"__________________----- Priv ''Distance from,nearest wee I----------------------------------- Y' �.I-. r , k x -------------------- ----------------- i ❑ '0Distance,to nearest lot line--------------------------------------------------------------- TT, Remodeling and/or repairing (desc�ibe):_-_____"." -- - 7`a-------=�� / .l' ` ' ------ /ri ----d---°±--- -` -:-i------------------------------------------------------------------------- ----•------------- -------------- "�: ------------------- -----------------•------------------------------•-------------------------------------------------------------------- ... ------ —.T-s' i,.i --------- ------------------------------------------------------} �.'i P application , , I hereby certify that I have re ared this a lication and that the work will be dans in accordance with San Joaquin County ordinances, State laws,:aacl les and regulations of the San Joaquin Local Health District. : p I • -11 04. _ and/or Contractor) L` Ow n (Signed) /fir 5 ---- (Iis,- ; =--- --------------- ar Tt a_ r�� _ - tBY:------------------ ----- ------" ---- """ " laced on reverse side). (Plot plan, showing size=of-lot.,location of system in relation to webuildings, etc., ca e p i FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED B ------ " -------------------------------------- DATE------ ----------------------- REVIEWED BY ----- ----- DATE------------------------------------------------------------ _ --------- ------- DATE--------- ------------ ------ - --------------------------- BUILDING PERMIT ISSUED --- ---- ---- - --- - - ----- --- -- - - -- ----------•------------------------------------------------------- Alterations and/or recommendations:___-___��j�s--- -� � --- ----------------i------- ---------------------- ------------------------------------------------------ ------------------------- - -- -------- - -- 1 3116 5� -------------- -------------- FINAL INSPECTION BY:.".-- .- -"�`f--�----------------------------- - ------ SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hasallon Ave. 300 West Oak Street 124 sycamore Street 205 West 9th Street Lodi,California Manteca,California Tracy,California Stockton,California _ F.P.C C.