11676 - Laserfiche WebLink

Home Browse Search

14 ° 0 ftW(-e__ � -) I ( P-�a APPLICATION FOR SANITATION PERMIT Permit No. ..&. ....... ...42 Vi (Complete in Duplicate) � Date Issued This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. �� N-� corner JOB ADDRESS AND LOCATION._-.___9_Sunset- & Maple.•.Drive-;.---$ 71_.Jo �qut__-R�.4ex____Club------- OOwner's Perata Lucerne 10611 wners Name .•------ -•----- --------------------- ----- ----------------- Phone ------•-----......---•----- Address_ 21109 Willbean,.,-_..Castro-_Va.lley.-------••-------•--•--------------•-------••--•-----....---------•----------------- ------------ - Contractor's Name`T-_'he DAY & NIGHT SepticTank_ Service046___-_--__ • __ _ --_._._----------------------------•. .._ Installation will serve: Residence MC Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units....... Number of bedrooms . ___.. Number of baths _Z___ Lot size ----5 .t_.____X.Adsar"__�S._...__..._ Water Supply: Public system ❑ Community system [X Private ❑ Depth to Water Table -1L ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam [N Clay ❑ Adobe)] Hardpan ❑ Previous Application Made: Yes ❑ No)g] New Construction: Yes 91 No ❑ FHA/VA: Yes ❑ No TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well__&50-1---Distancg from foun ation__-10.1_-______.Material____CC Brick _________________________________________ Ki No. of compartments_--__2.................Size__5�!?;36"_X631iquid depth...53"------.--------Capacity.....$00--_Gals, Disposal Field: Distance from nearest well--- s�_t.__Distance from foundation___10.=_....._.Distance to nearest lot line_______5.1-__-- PC Number of lines11111, __ _____________________________Length of each line_ ' +Width of trench__ ..._....._.._._____.__.____.__ Type of filter mate ria l_Sep --- k---Depth of filter material_-_1810___-_--.-_-.Total length------1Q7..._.'�__________________ Seepage Pit: Distance to nearest well----------------------Distance from foundation....................Distance to nearest lot line___-_._--_--____. ❑ Number of pits----------------------Lining material---------------------..Size: Diameter-----------------------Depth--------------------------------- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material----------.-__---__._--------_.-•-_-. ❑ Size: Diameter--------------------------------------Depth----------------------------------------------------Liquid Capacity............................gals. Privy: Distance from nearest well-------------------------------------------------Distance from nearest building--_-----__-__.-___-__________---.----___-. ❑ Distance to nearest lot line--------------------------------------------- -----•----------------------------------------------------- Remodeling an /or repairing (describe :10-7#_•X-_.36"___wide________321 Sq, Ft, a 41. d j� ------ - --------- ------------------------ 1� �° 'S�'5. 1ne� --------- --1--'Z'--------------------------------------- ----------------------------- ---------------------------------------------------------------------------•----------•-------.------------------------------------ ------------------ ------------------------------------ --------------------_------------------------------------------------------------------------------------------------- I hereby certify that I have prepared this application and that the work will be don accordance with $an Joaquin County ordinances, State laws�lr�d rules and regulations of the San Joaquin Local Health District. (Signed) - ------------------------------------------------------------- -- Contractor g 8EPTIC TANK._S 111GE o/ ,./v. ... Title__... - - � ----------------------�---•-•---------••------ ( ) (Plot plan"sfiowir 98010116Y A-ZOM of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--------------------_f_ C _ DATE.---_.-._-_._ ._,,._ ------------- REVIEWED BY .- �--- ------------------------------------------------ DATE------------------------------•---------- ----------------- BUILDINGPERMIT ISSUED...................--------------------------------------------------------------- -----------------. DATE------------------------------------------------------------- Alterationsand/or recommendations---------------------------------------------- ------------•--------------------------------------------------------------------------------------------------- -------------------------------------------------------------- ------- ---------------------------------------------------------------------------------------------- --------------------------------------------- - -- - -------------------- ----------------- --- --------- - ----------------------------------------------------- --- CFINA ------------------------------------------ L INSPECTION BY________ Date ' SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M Revised 8-'59 F.P.Co.