5806 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. �- -- '- -- `----- in Duplicate)— ` Date |sme6/_)_-3.r_��.�� A |�u+on ishereby o6n theSo Joaquin Local Health Difor a permit to construct, ||the c,k rein described. application is made in compliance with County Ordinance No. 549. InstaUa+|on will sen/e: Residence W Apartment House [] Commercial E] Tm||e, Court E] Motel 11 Other [l Number of living units-. /_' Number of bedrooms «%-' Number of baths Lot size ��Y��.�..m«..I.ro°.------ Wafer Supply; Public system El Community system El Private UC Depth to Wafer Table 47ft. Character of soil to m depth of 3 feet. Sand [:] Gravel Sandy Loom 10 Clay Loam [] Clay E] Adobe [] Hardpan [� Previous x\pp||caf|*n k1m6e: Yes L] No X New Construction: Yes R] No 0 TYPE OF INSTALLATION AND SPECIFICATIONS: � (No septic tank or cesspool permitted if public sewer isavailable within 200 feet.) ^ Smp+|o Tank: Distance from neun,xf weU-4-0 f - ion- ---------------- --99 No. ofcompartments...... A�----------`�Sizu �� ..Liquid dep/k'9�.----------------Copacity. � �---40--. Oispoom| Field: Distance from U YAl.'�1 ^ ~ , �0 Number of lines--------:iLength of each line-----5-41- VV|dtk off renc ---- Type cJ �|+orm�fo�u|-~�^ �eo+ of filter m°+��uL- --�-.To+a| length-----��_-.--._-- Seepage Bit: Distance to nearest weU-''--�-��-Distance from foundation ''''-_'-Distance to nearest lot line-'�-''- [] Number ufpits---------------------Lining material -_----Size: Diameter_-------Depth---------.----.. Casspoo|: Distance from nearest well----'-Distance from foundation....................Lining mofnriuL-----------. [] S�ze: Diameter _''''-'''--'��Deof -''''--.'''''-''''''_ ....Liquid Copuc��'-''--�-'-'.gu6. Privy: Distance from nearest wO-------------------------------------------------Distance from nearesf building---------------------------------------- El Distance to nearest lot line.-'--�''''-'''-''''_. ------------------------------------------_'''-_''-'-''_.'�----- - - Remodelingand/or repairing (clearibe\:_------ ----------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------''--'--'-'--''''------''------------'--------------'--------'------' ---'--.--_'-''---'-''--.'-__--_-__----_'--__''-_'_-__'''-__-'-_.-''-'''----_.--''''---'''-_' . ---.-__--_---_--_.--_-__--..___.--._--_-__..__'_-_'__---_-_----__-_----_-----. \ i hereby certify that I have prepared this application and that the work accordance with San Joaquin County ordinances. State laws, and rules and, regul fions off the San Joaquin Local Health District. ��nad�. ..-��. ------------------- =n6/o, By:---------------_ --''---'''--'-'-''-'--_____ (Plot plan, showing size of lot location of system in nw|afiun to wells, 6wUd|ngs, etc.. can be placed on reverse side). F ARTMENT USE ONLY Olt APPLICATION ACCEPTED BY---- -- ------------------ DATE------�iYAVOV- --- ----------------- 8U|LD|N6) PERMIT ISSUED------------------------------------------------------------------- ---------------------------------- DATE-----__-------______. Alfm,ufionu.on6/�,J��o�men�mHons�------_--.-----'_---_-.-'_-___-_-_-_'__-.__- -___' -'- -- '''---' -'~ ' ~�- '-''- "== ----'-= �'=`f-`'`---'^°~=`'`�='-+,��"-' --- `--- --��°~��-��u z��---------_ _—_-.-------.---._----------_-----------._---------�----_-._�--_-----'----- ' . . -''-'-''-`''''-'''_''--'''-'-''''_'''_-''---'--'''---''''-''`'''-_'' ' ---------------------- '-''-'-_--_ _ FIN/4L INSPECTION 8Y:-- ' —''''-''_. Du+o-- . --'-'''---''-''- SANJOAQUUNLOCALHEALTHO0GTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street m* xorth "C" Street sfo"kf" . California Lodi, California Manteca, California Tm"v, California sS-9-2m m',o xo~i"vd vv'x/oo '