Laserfiche WebLink
Date FINAL INSPECTION BY:..._, <br />..... „ ,Perrtelinetett6r Contractor) <br />(Fife),. <br />‘_. Jeuildipge,,etc., can be placed an reverse <br />PARTMENT USE ONLY <br />By: <br />(Plot plan, shclwinTsize tof lot, location of system <br />Signed). <br />APPLICATION ACCEPTED BY, DATE_ REVIEWED 3Y 4 <br /> BUILDING PERMIT ISSUED DATE <br />DATE . Alterations end/or recommendations: <br />FOR OFFICE USE: <br />• <br />Permit No, ,.../.. ...2...4.(3 ' <br />. (Complete in Duplicate) <br />Date -Issued This Permit Expires 1 Year From Date Issued ;- ---- • <br />Application is hereby made to the San Joaquin Local Health District for e permit to construct and ins-tall the work herein described. <br />TH.. application is made in compliance,win County Ordinance No. 549. <br />Ser. e 104/722fel.0940/ <br />- - .. Phone. <br />Installation will serve: Residence 0 Apartment House 0 Commercial W2c...roiler Court 0 Motel 0 Other 0 <br />Number of living units: _.••-ee-.._.. Number of bedroom's !".-.---._. Number of baths /.... Lot the 7.,07.47A( ...v.e7,9 / -_ <br />, , <br />Water Supply: Public system 0 Community system 0 Private [?rbepth to Water Table ‘.4.0.`. It. <br />Character of soil to a depth of 3 feet: Sand '-Gravel 0 Sandy Loam 0 Clay Loam 0 Clay 0 Adobe 0 Hardpan 0 <br />Previous Application Made: ' If yes, dote ) No %'•-•"*New Construction: Yes 0 No g?'-Fl-IA/VA: Yes 0 No kr.L.... <br />TYPE OF INSTALLATION AND SPECIFICATIONS: <br />(No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br />Septic t ank: istance•from nearest we.I _ ,....Distance from toundation„ ........._ Matet,jal.. 41— Ire"- No. of cornpartmenic or-• Size eie9C.,‘ VAP.4" Lig u id depthreeS./ , Capacity rfPc'ePz e , e e Disposal Field: Distance.from nearest well,,,e, Distance from foundation_f‘i Distance to nearest lot me__ ..... I l' 0.404—/ Number of lines ' / j Length of each line .eW," .i., Width of trench ele' ..,, 1\-• <br />32..."- <br />Type of filter rnaterial/(APM- Depth of filter material ei /Cr'' Total length.. <br />Seepage Pit: Distance to neorest-' well Distance from foundatioe Distance to nearest lot line.......... 0 Number of pits Lining material Sim • Diameter Denth <br />Distance feom neareo- well.. Distance from foundation.. Lining material Sim: Diameter 'Depth Liquid Capacity , gals <br />Distance from nearest well Dirtence from nearest building <br />Distance to nearest, lot line <br />APPLICATION FOR SANITATION PERMIT <br />$ <br />JOB ADDRESS A1D LOCATION./a <br />Owner's Name__ <br />Contractor's Name__ <br />Cesspool: <br />Privy: - <br />0 <br />Remodeling and/or repairing Idescribe)e... <br /> 6.3014,1:1?7.te. <br />hereby certify that I have prepared this application and that the work will be done in aocorclance with San Joaquin County <br />ordinances, State laws and rules and re9ulati. s of the San Joaquin Local Health District. <br />1601 5, thaseiton Ave. <br />Stockton, calteerea <br />CS 9 neviSEO bi-S9 <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />300 West Oak Street 124 sycamore Street <br />Loth, Cedifernies Mawr:Ka, Cøhf.nn ic <br />TOS Welt 9th Street <br />Tracy, California