18237 - Laserfiche WebLink

Home Browse Search

------- ---------------------------------_------ ------- ?_q % APPLICATION POR SANITATION PERMIT Permit No. - ------- -------------------------------------- --- -- (Complete in Duplicate) y }� 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. IA ,�JOB ADDRESSND �[ AT10 ;---- ----- -P fes` ' ------- - ------�----ApF'QYl 7---: Owner's Name- "a /••r ��-� -_ _ __I__ t-, ---------------- ---�� ...� .� _.,..,»� _ -- -' -------'-- hone-----'--------'----------- ------- Address .KT�.�-- --------1��----- 1�,�-.� � "=�1�TF�_�UP ----------------------•-----------•-----_ -„ s -.;_ Contractor's Name------�� /v �, Phone--------•------------------------ Installation will serve: Residence e Apartment House Commercial ❑ 'r. p ❑ ❑ Trailer Court ❑ �Mo�tel ❑ Other Number of living units: --I----- Number of bedrooms 3--- Number f baths ---/--- Lot size ____ .�?___.. ____ SQ________________ Water Supply: Public system E] Community system El Private Depth to Water Table - _- ft. .' Character of soil to a depth of 3 feet: Sand Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ AdQ6e ❑ Hardpan 4. Previous Application Made: (If yes,date____________________) No New Construction: Yes to 0 FHA/VA: Yes FNo ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: I�'I _(No septic tank.or.cesspool Perm itted,.if public sewer is available Ta t , within..200-feet.)- Septic feet.)W Se ticnk: Distance from nearest well___ _ ,Dstanc from foundation-__1/0________.Material_..O/V; A.6:_71_ ___ ----- No. --__No. of compartments 7L---------- .Liquid depth---- _ __._Ca Capacity--/ 01m . ! �] �t Disposa�ield: Disfiance from nearest well--.�C7-----� �Q___-____.Dist�nce,to nearest lot line___�_�_._________ istance from foundation____ .. � Number of lines__________ _____ _______.__Cen th of each line____ _ _ -- 9 ��-fit- - --Wid,th.,o� J.�.7-----�.-------=---- Type of filter materiaL__AQ.C_�,Depth of filter material_V/________-____._Total' length-----------11_t�__ __ _ ________ Seepage Pit: Distance to nearest well--------------:, _._Distance from foundation----_--------------_Distance.to nearest lot line____-_.______.._ 1r� �,..« '" i ❑ N�tuber of'pits----------------------Lining material-----------------------Size: Diameter.-.--------- ---Depth------------------_____:--------- Cesspool: � Distance from nearest well______.._-_____Distance from foundation___._____._-.._.__.Lining material------ _____________________I I El Size; Diameter----------------- ----- / ------.Depth------------------------------ -- ----------------Liquid Capacity--------- ----------------gals. yyy3 Privy: 3Distance from nearest well _ _I__ ----------------Distance from nearest building__ ___________--- ❑ Distance to nearest t.lrne --- -• ----------------------------- o f I..",. " Remodel in ,,and or repairing describe � H.___�A._!-� "9�_�3i'_ --------------------------------------------------------------- - --------------------:�.------------ e-;E'_�`'_,._Y, -..-------------------------- ------------ ----.------------------------------------- ------------ w - < .e ------------ -----•------------------------•--------------------------------------------------- ------------------------------------------------------.----------_ ---------------- ----------- . a -- I hereby certify that I have prepartd.th,is. application,and.that-the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin:Local Health District. (Signed)-----------.----- . '-S " _____---__-- L, �..., {Owner and/or Contractor) ------- ------'--- --- ------------------------------------- ------------------ ----------------- ,. _— - __Bye •_ _;-:--- ------:--_-------------------- _-------------- ----:--------------------------------------------------(Title)----------------_-- ------------- (Plot plan, showing size of lot, location of system in relation to we_lls,'baildings, etc.,Can'be lilaced_on reverse side) - FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY----_.- __�_ _._ _ —� - ---- ------ ---------------------------------------------------------- DATE 2-25 REVIEWEDBY--------=------------------------------ .......:-------------------------------------- -------------------------------------- DATE-- -'-'-'--------'------------- - BUILDING,PERMIT.ISSUED---•----__--------------:_:-- r----:._ ---------------------------------------- DATE--------------- _ :. r.�. Alterations-and/or'recommendations _./�_� -�=._�r�. ----------------�- -- -- ---------------------'------------ - !"r�, - 1= -------------------------------------------------------------------------------- --------------------------------------- --------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------- FINAL INSPECT � --- --- --'- --- Date---- /�--- rt ' ' ' SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 S.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,Califorbla . Manteca,California Tracy,California F.Rru..