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APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) 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. I JOB ADDRESS AND LOCATION-------- �-----2 _1-�-Wft£E'�---�QI�TD�.1------------------------------------------------------ ------------------ -------- Owner's Name----------WILLIAM E,_-F'KAT_dKLlht-------------------------------------- ----------------------------------- Phone--Nq--------------------------- 21 We$t-_Lowe11__A--VAA-------------------------------------------------------------------------------------- -----------------------------I------- Contractor's Name........P'---A._-F ----INC_P----------------------q-------------------•--0--------: Installation will serve: Residence ® Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑-, Number of living units: M Number of bedrooms 21 Number of baths ® Lot size________ x---1101 _________________________ Water Supply: Public system$,$ Community system ❑ Private ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ® Hardpan ❑ 1 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-________________Distance from foundation--------------------Material------------------------------------------------- --------Capacity----:------------------Size-------•--------------------•-•-Liquid depth-------------------------- ❑ No, of compartments__________________ - ._ ----- Cessp_ ool: Distance from nearest well_________________Distance from foundation materia___________________-_ ❑ Size: Diameter---------------------------------------Depth--------------------------------------------------- 'Privy: Distance from nearest well_________________________ -----------------------Distance from nearest building------------------------------------------ El Distance to nearest lot line_______________________________________________ None r Seepage Pit: Distance to nearest well_________ __________Distance from foundation-39-1 #o nearest lot line Ci�+` BXUlSize: D.iameter__. �� Depth 18 Number of pits--------- Lining material.___________ �* TDisposalField:. Distance.from_,nearest well_QX1e____,Distance.from.foundation___13a�=_:_______Distance._to nearest lot line--- -Disposal _? Number of lines_______1________11 Length of etch Ime24 ' ----Width of trench ��4 ---------------- Type of filter material------�- 11---Rk-Depth of filter material___-_18--__________ Su le ent to-_e_ 3�_ G �.ra1nag-e---6y_11t.eM...off------------------------ Remodeling and/or repairing (describe}_______________Pp____________________- -----------ex $t n � t� ---teMk-s----------------------------------------------------------------------------------- --------------------------••----------------------- ------------------------------------------------------------------ ------------- - ' I hereby-certify that I have.prepared this 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)-- Da A. PARRISH & _SO.N _-_-- IN_G`±-------------------'---------------------A----------------------*------------- Contractor) (Title) Eetima'tor BY�-------------- �' `"' ,� (Plot plans, showing size of lot, location of s4m in relation to wells, buildings, etc., must be filed with this application). 1 FOR DEPARTMENT USE ONLY 1 APPLICATION ACCEPTED BY----__ - -- -- ------- ----------------------- DATE------- /� ---------------------------- REVIEWEDBY---------------------------------------------- -------------------------------------------------------------------------------- DATE------------------------------------------------------------ BUILDINGPERMIT ISSUED--------------------------------------------------------------- ----------------- DATE-------------------------------------------------------------- Alterations and/or recommendations------------------------------------ ---------------- ---------------------------------------------------------------------------------- -----------•--------------------------------- ---------------------------------------------- - -------------------•-----------------------------------------------------•---------------------------------------- ------------------- / -- ISSUED-- ��'�- -----------(Date) FINAL INSPECTION BY:------------ --------------------------------- PERMIT Nq�___UI-- -------- --- ---- Date--------------------------- ---- --I-L----------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton,'California ES-9-2M 9-50 W=1639