Laserfiche WebLink
Remodeling and/or repairing {describe)- <br />--.....c <br />Permit No. 1•••?/ <br />Date Issued <br />APPLICATION FOR SANITATION PERMIT <br />(Complete-in Duplicate) <br />This Permit Expires 1 Year From Date Issued <br />FOR OFFICE USE: <br />Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br />This application is made in compliance with County Ordinance No. 5 9. <br />JOB ADDRESS AND I1OCATION 4- 47/ <br />Address a <br />Contractor's Name Phone. I 3 9 02-- <br />Installation will serve: Reside IX Apartment House 0 Commercial 0 Trailer Court D motel 0 Other D <br /> <br />rIrNumber of living units: / Number of bedrooms #/- Number of baths . / Lot size ql . <br />Water Supply: Public system 0 Community system D Private )r Depth to Water Table,. ft <br />Character of soil to a depth of 3 feet Sand 0 Gravel Sandy Loam Clay Loam 0 Clay 0 Adobe" Hardpan 0 <br />Previous Application Made: (If yes, date I No re New Construction: Yes 0 No X FHA/VA: Yes 0 No a <br />TYPE OF INSTALLATION AND SPECIFICATIONS: <br />(No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br />Septic Tank: stance from nearest well <br />No. of compartments <br />Distance from nearest well. 670 <br />Number of lines .1(5r4tti <br />Type of filter material. . Depth of filter materiat. /57 <br />y. <br />Length of each line e "" Width of trench. 4:1X ....- <br />Distance to nearest w ' ok / a Distance fm f <br />/ <br />2undation.‘41 isili <br />Number of pits.....)1(.... _ _t__Lining material../.. .. ....Size: Diameter <br />Distance from nearest well Distance from foundation Lining material <br />Size: Diameter. Depth Liquid Capacity gals. <br />Distance from nearest well D:stance from nearest building <br />Distance to nearest lot line <br />Owner's Name Phone <br />Disposal Field: <br />Seerp <br />Cesspool: <br />Privy: <br />El <br />Distance from foundation Material <br />Size Liquid depth Capacity <br />e • • ...Distance from foundation...IV Distance to nearest lot line...NS: ...... <br />Total length eVa "e"" <br />Distance to nearest lot line *.? r Depth._ <br />I hereby <br />ordinances, <br />tify that I have prep d this application and that the work will be done in accordance with San Joaquin County <br />laws, and rules a .ulato g t e San J quin Local Health District. <br />(Signed).... <br />By:. (Title) <br />and/or CoMfeefor) <br />(Plot plan, showing size of lot, location of system in relation to wells, buildings. etc., can be placed on reverse 4:7-1-44-4--"Iside). <br />FOR DEPARTMENT USE ONLY <br />APPLICATION ACCEPTED BY <br />REVIEWED BY DATE <br />BUILDING PERMIT ISSUED DATE <br />Alterations and/or recommendations: 64, aye, <br />X. • 0•1. <br />DATE 517 376 S7 <br />FINAL INSPECTION BY- ........... Date 5 ilk I a <br /> <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 E. Hazeiten Ay*. 300 West Oak Street <br />124 Sycamore Street <br />205 West 9th Street <br />Stockton, California Lodi California <br />Manteca, California <br />Tracy, California <br />E.H. 9 2M 1-67 Vanguard Press