17873 - Laserfiche WebLink

Home Browse Search

rUKUI--HCS USE: ------------------ --------------------------------- __ --- -------------._.-- -----------------------_--------.----------- APPLICATION FOR SANITATION PERMIT Permit No. ------ -------------------------------------------------- - (Complete in Duplicate) Date Issued --------------------------- This Peit ix ires 1 Year From Date Issued rm �`e -(a0-3� Application is hereby made to the San Joaqu n Local Health,,District for alpermit to construct and.install the work herein described. This application is made in compliance with County'Ordinance No. 549. .2 t 64Y 95. C-�to.i )4_11C__ + I i Q ------- JOB ADDRESS AN LOCATIO --------- _JD .._ _ /1ifD_!\ ----_-- 4-- vs1,c------ ------------- o-FigRo` Owner's Name- ------------------=--------------------------- - ----------------------------------- Phone------------------------------------ /. _ . Address---------- --_2.•------13O -------- - �--------- 1. - ---O1�_--'-------------------------------------------••-----•--------------------•------------ X --, - Contractor's Name-±e-_V_V1V_P_1_1__P-------5F—PTi!C----S PAI 11-4 r—a ------ Phone----------------------------------- Installation will serve: Residence &Apartme It House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: _/----- Number of bedrooms _ _ Number of baths /____ Lot size __-- ___�__________________ Water Supply: Public system ❑ Community system ❑ Private kr"`bepth to Water Table 3_rft. Character of soil to a depth of 3 feet: Sand Gravel Elik. Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: (If yes,date........... ... ) No New Construction: Yes [R"No ❑ FHA/VA: Yes Q--No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: cr (No septic tank or cesspool permitted ifululic sewer is available within 200 feet.) Se tic nk: Distance from nearest ell__-_,��____Dist e from foun anon__ _ OI\!G-- v Njate gal--..�__ p - No. of compartments--- fl-_�_--------SizeXT_1_'_-_.]___;__Liquid depth__ Capacity_- ,? _`_ � _ ..�� .ti p Distance from foundation.-- -.-__---Distance to nearest�lot Dis osal field: Distance from neares# well ----- - Number of lines_______.. _ __ _____Length of each line_-�_r_l47........_--._.Width of trench ____.. i, f--------- Type of filter material___-�6_G�G----Depth of filter material___---1-- Total length______-__--. -��________________ Q � 44� Seepage Pit: Distance to nearest well........___-.-------Distance from foundation___________________ Distance to nearest lot line-.-___________-__ ❑ Number of pits.-------------------i Lining material---------.-------------Size:..Diameter,--- -- -----.-------------Depth------------------------_---- -- ` f ll`h Cesspool: Distance from nearest well_---I----------Distance from foundation Lining material-____________________________________. ❑ Size: Diameter---------------------- -.-----Depth------:------------------ -I- Liquid Capacity. - ------------------------gals. e Privy: Distance from nearest welE______ ___________________________-___-------.-Distarce from nearest building-----._..__---------_-__-_---__...__-_._. ❑ Distance to nearest lot line. ------------------------------------------------------------- -------=-------------------------------------------------------------- ------ --- ----------- -i r Remodelin and/or repairing describe -------- -�----(--------------- ----- - - 9 p 9 � --------------------------------- 1 -. -- 1 - ----- ,_-------------------------------- _. — 4 ! t I ----------------------------- ti -------=' �--- •------------•----•--,--------------•------------------------------------------------------------------------ 1 Ct I I x r I hereby certify that I have prepared this application and'`thaf the.work will be done in accordance with San Joaquin County G ordinances, Stye laws l and rules and reg a ions of the San J quip Local Health BY� � Dstct -- ---- - --- ----------- --------- - - -(Owner and/or Contractor) (Signed) -------• -•------------------------------------------------------ ------------------------------------------------(Title)---------- -------- ------------------- -------- -------------- (plotplan, 1 plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side]. FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-------7n.Ka_0, r 7 DATE_ BY-------------------------------- ------------ -------------------------------------------------------------------------------- DATE BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE----------------------------- - Alterations and/or recommendations----------- ---------- - --- ------ - - -- - --------------------------------- ----------------------------- ---------------------------------------------- - - - - - ---------------..--------•--------------------------------------------- ------ ------------------- -------------------------------------------------------------------------------------- ------------------------- ----------------- ------------ ------- -----------------------------------------------------------------------------------------------------------------------------•--- ------ ----------------•-------------------- ------------- L FINAL INSPECTI Date-------------- .- . r ? ___------ -- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak StreAt 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California F-P.CO.