72-481 - Laserfiche WebLink

Home Browse Search

_ .v.. A- VOR OFFICE USE: r� pppLICATfON FOR SANITATION PERMIT Permit No: ---7.� �.-- - -- ` t "" {complete in Triplicate) S L --------- } _ .. ----- - Date issued ------------- --- �. This Permit Expires 1 Year From Date issued ante permit it t and existing Rules and Regulations: the San Joaquin�to al Health District ifs�or a permit to construct and install the work herein Application is hereby made to J y S O described. This application is made in compliance with County A CENSUS TRACT JOB ADDRESS/LOCATION --- a5q '----------=- ---Pho a ------------------------------------- 6- ---------------------- ;, _ <?Name --- Q - Cit ---RAF ---------------------- owner's C�1 Phone License# ------------------- Address gfONi ! Contractor's Name _._ _ Commercial ❑Trailer Court `❑ Residence ❑Apartment Nouse❑ all.•serve: ' lns�plation..: - L fi e ' Other ' • -- - " -- ., nits:"-.- - Number of ',bed o Size } ;.1�Motel,E] �.. r `11 _-_._Garbage Grinder E l rooms __ --- ---- Priv Number of jliving u f ---- a --------------------- c - - - .. ate . 1 Public System and name --------------- ` ysa'i,'dy Loam-1O.,c-�Cla. .L rr►•-- _� Water Supply: Silt, j Clay '❑ Peat❑ i > -�--r-�; a ---- ------ L = Character of soil to a depth of 3 feet--San ' 1 , t Fill Material _6-_ if Yes,type }-Hardpan ❑ Adobe {] r---t^^_ .. "" placed on reverse side.) M• s buildings, etc. must be i system in relation to wells, (plot plan, showing size of lot, location of, sy i l it ermined ;f.public sewer is available within 20d feet, 1 �•." ` NEW INSTALLATION: (No septic tank or seepage p p Liquid Depth -"---- G SEPTIC;TANK![,F] 1 { .; ige------------------------------- ENT = 1 PACKAGE TREATMENT L 7 - -�;,�:� No. Compartments "" `!`� - - aria) ` l �; Type -= "= Pro Line ----------------------- Capacity ; f k -Foundation "-------------------- p � "+stance to nearest: Vllell _- ) Total Length ---------------------------- D • Length of each'dine--�.------ - t No. of Lines „ F l Depth Filter Material -------- `}: - LEACHING LINE I } ` yP Filter Material ----------- V -----== f=: s :p' Box:-----l- T e', s s i -- ---- Property Una ,- r , ,�__�� - r_ N 4 1-Distance to nearest: Well __.- Foundation a Rock Filled- Yes ❑ _ ----- Number --------- .r i � e'.?h --------------------= Diameter ---- ----:- ( + SEEPS L 1 +� rp Li. __--•------------- Rock Size lis ..1 ` 4 . Water Table Depth- ----�---- s Ljne -------- ------------- Foundatlon Prop:w 1 -------- l } F Distance to t Barest: Well------------------- # } r Date,--- ------------- ----- F ---- REPAIR/ADDITION(PrevSanrtation Permit# ---- f "__R • ___ _ Septic Tank (Specify Requirements) -- , _r. I� �i ------------ d x 1 �:��-------- � E4 N` e6f Requirements) _ #Yd i - ------------•--•--------- Disposal Field (Sp Y t ? �i tet' -------- .___ i ____________.-- (draw existing and required addition on reverse si e i lication and that the work will be done in accordance with San ome owner,Joaquin I hereby certify that { have prepared this app County Ordinances, State Laws, and Rules.and Regulations of the San Joaquin Local Health District. 'son in such manner sed agents nature certifies the following: ' •-', • err"{t is issued, I shall not employ-any Pg "I certify t 'n the erform ce of;the work for,whicl;t this p , } as to beets'y. subje to W rk an's;Compensa`,t*on lawsof coliforniaa."Owner ------ ---- Signed a�t tl = --- . -- -- ------ - ___ 4 FO i By "" -"-"- ------------------------------------ (if other than owner),-1 zaz L-- _ R DEPARTMENT USE ONLY DATE. APPLICATION APPLICATION ACCEPTED BY . rDATE -- ------ --- -M-,MN-.T BUILDI.NG_PERMIT__ISSUED= ADDIAL COMMENTS - - - ----------- -----Q- ---�----F--j--:-�------1- - T . ----------------------- ------------------ ---------- --------------_. - - ---------------- -------- -------- --------- -------------- -- ---- - Date _ � r -- ------------- Final Inspecti t SAN .10AQU1N LOCAL H1:ALTH DISTRICT y r u 0 1-'68 Rev. 5M