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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 t This application is made in compliance with County Ordinance'No: 549. E he work herein described. JOB ADDRESS AND LOCATION___-_-_-_53s_--------------------------------------FL# Weber Ave. . . 13tocklaan, Calif -- - - ----------------------------------- -- ----•-- Owner's Name--------------RObert �Qusez�eart -- - -------------- -------------- ----------- --- - 9' 50 27 -- - ------------------------ ----------------------- ----------- Phone----- - ------------------------ Contractor's -- 3. 0 �. Weber eve. . ,, ------- ------------ Address--------------- -_----- - - --------- --- --------------------------------------------- ------------------------- INCContractor's Name--•-- -'•---,i' P ik1Rx Fi & SONS a o - ------------------------------------------------- ------------ Phone__P �0�7---------- Installation will serve: Residence MC 'Apa4�hent House ❑ Commercial ❑ Trailer Court Number of living units: [l .Numbyof bedrooms ❑ Motel ❑ Other ❑ `� [� Number of baths Water Supply: Public s stem Lot size__-__-- 0---_--�-_-12Q 1 PP Y� ` "' - i--------------- Y ❑ Community system ❑ Private Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Glay Loam ❑ Cla y ❑ Adobe& Hardpan ❑ 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_____6p-1----Distance from foundation-- 10�____" No. of compartments____- ____ Material___ 1- 'C-CerrEPl7t-T�I'7 Cil ----Capacity-------- au---GSize5611 � 611 �E it )igwd depth-------5 ---- Cesspool: Distance from nearest well-----------------Distance from foundation_-�---� -"__Linniinng material-_""--_"- ❑ Size: Diameter--------------------------------------Depth--------- Privy: Distance from nearest well----------------------------- Distance from nearest building ❑ Distance to nearest lot line-------- g - r ------------------------- See a e Pit: .. 1: " �� t P g Distance to nearest well "-_-----_Distance* 1 ` . - ` A from foundation-_ -S•__-__"-___.Distance to nearest lot line__"--. of pits------�-------------Lining,meterialO re--C em --------- Numberric Diameter------ ft 2� Disposal Field: Distance from nearest well"--_ 0_�_--- -Depth________ _________, _ Distance from foundation__--___12�__- Distance to nearest lot line__�-_t t Number of lines____.--__--1 a __-_----_ ---Length of each line-------- ;-_ I; Type of filter material--- -j------ ---- h----------Width of trench------2�,______" Depth of filter material----"12-_-. Remodeling and/or repairing (describe)------17om alle- _0 11 --------- �°---'""' ----------------- # ---------------------•' ------------------ ------------------------------------------ • =------------------------------------------------------------------------------------------------------ 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. i Y q (Signed)----- - ---- S 8c uQT�I� T 1 ----- ----------- ------- `. g ----- -- - M�or Contractor) Plot Plans,Vowing size of to},*Iota}ion of s s I-- --- -------•------:, ---------------(Title}_--Xstimat r y tem in relation to wells, buildings,. etc., must be filed with this application). f FOR DEPARTMENT USE ONLY f:� .APPLICATION ACCEPTED BY - ------ DATE------- -- - - REVIEWED BY------------------------"---------•- �-- ------- -------- - --------------- --------- --��--#' --<-- --------------------------------------------- ' DATE ----------------------- v ------- BUILDING PERMIT ISSUED----------------------------- --. �--------:-------------- - ------------------------- DATE Alterations and/or recommendations • ------ ------------------------------------------------•---•-------------•-------------------------------•-------------- .. - ---•--- ,Za e. T� ------�7,C a- -- UJ6----- ------�f�C.4- /-- � Q i -r- -ra 0W-------------------------- ' � a �s�--�'-------------------=°---- ------------------------- --- `1 :''� - `� PERMIT No � -----•----------- ISSUED----�� -z-a-T/ -. - ___ I -------------(Date) FINAL INSPECTION BY:--------- - Date � SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street ES-9-2M 9-50 W=1639 Stockton, California