Laserfiche WebLink
FOR OFFICE USE: .......... PERMIT permit No. <br /> -------------­------ <br /> ........ ...... ------- 0. APPLICATION FOVSANITAT, 10N. <br /> --------------------—....... .5 N I <br /> ........ ­--------------- (complete in Duplicate) Date Issued <br /> --- This Permit Expires I Year From Date Issued <br /> Application is hereby made to the Son Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance nce with County Ordinance No. 549. <br /> ` <br /> t <br /> ... ........ <br /> .................. ....... <br /> JOB ADDRESS AND LOCATION_-------------_-- -------------------------­_­...... <br /> ---- --- ------ <br /> 1;7 . _ ---.!.............. <br /> I — None.. <br /> ..............I--------- ........ P <br /> Owner's Name----• ............. ................. <br /> Address-- :L,—. --------- ...................................... <br /> ... Ph - - ---------- -- <br /> ---------- ...../--------- <br /> ContractorsNa6ed ......d -••--•--•---••••-••--•-----•••--------.--•-•••------ -- one---•.................. .......... <br /> Other 0 <br /> L] Commercial la--frailer Court [I Motel 11 <br /> Installation Will serl�l Residence [I Apartment House <br /> x - 4llI 1 ...I------------------_-_------------- <br /> Number of living Number of bed raorns-7__ Number of baths Lot size <br /> epth To Water Table it. <br /> Water Supply: Public syste 0 Cornmiunity system 0 Private 9--6 <br /> :1. 1 -] Adobe 13--flardpan[3 <br /> Character of Saill'to a depth of 3 feet: and Gravel Ll Sandy Loam C1 Clay Loam El Clay <br /> ---FHA/VA-. Yes [J No C1 <br /> Previous Applicafi&V..Made tr(ff.yes,-date--- -- ----4_q.1 No F1 Now Construction, Yes C] No 0 <br /> TYPE OF INSTALLATION&ND SPECIFICATIONS: <br /> (No septic tank or cesspool pe;mitfed if public sewer is available within 200 feet.) <br /> III li �efrort�foundation...A. ......Material.1c <br /> Distance from nearest well.j7i ....Distanc -•-•••••.•• e4 <br /> YSeptic Tgak, J f <br /> • of CoMParifTqnts..__ -------- Size Xz ...Liquid clepjb...........44J-------cap"city <br /> fteare <br /> from • <br /> nearesf'well+ 0•:.Distan rorn 4oundation........ ___0...Diitance to st lot line..... <br /> _% ' �of'trench...-........•------------------ <br /> Disposal Field: Distance <br /> M - �th of line____-----• ------ cit <br /> Number o4 linel -11 V�� e,A_11 '7% '­­------ <br /> Wi <br /> ' I............._-Total .............. <br /> ype of filter material_...._.:..._ .D�Pth-,of filtor.material------- <br /> 'a from foundationA.................Distance to nearest lot line----------------- <br /> Pistance to.nearest well------------------ -Distan <br /> Seepage Pit; Numbe"Ir of pits .-_------------------Size: (Siameter._.....--------------Depth---------------­-------------- <br /> L1 ---------1-_..Lining mater <br /> I n a from foundation...._____._____.-_..Lining Lining material- <br /> Cesspool: istanis from nearest well.................Dista c ------------------------------------ <br /> I _Liquid Capacity---------------------------gals, <br /> ------------ -----------�Depfh____.............. --------- ------------ <br /> ..!_----------------------------------- <br /> Pr;vy: bistanbfrom neatest well-_........ --- ----- ......Distance from nearest building. .......... <br /> -- ------------------- <br /> e -----_------------ ...... <br /> 0 A Disfan2e i� nearest Joe-lin ------------- ------------------ <br /> ' 7— ... <br /> Remodeling and/or top- %,(de;cribel; ...... <br /> -------------- -------- ----------------- <br /> ............ .....I----------------7------ -- ------- <br /> ----------------------------------------------- ...... ------.......--------------------............ ................. ------ <br /> -------------------.................... <br /> e 6 ?Fy thaf, have prepared this cation and th#lt�_- work will be done in accordance with San Joaquin County <br /> ce"' s f the San Jo ui Local Health District. <br /> ordinances, y rules an e a ' <br /> tian s. Sta laws, a <br /> -------(owner and/or Contractorl <br /> ... ............. ..... .. . ..... ---- ------I——....... ------ ----- ...... ...... <br /> ........... <br /> By:......------------------ .............------- ------------------------ ------------ ........... .................. ------ ----- <br /> (Plot plan, showing size Of:lot. location of system in relation to wells, buildings, etc., can be placed on reverse side), <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY........ t7/ <br /> . . ..2� ----------------------------------- DATE.-...: ----- ------------- <br /> DATE........ <br /> ......... <br /> --- --------------- <br /> ---------------------------.......------ <br /> REVIEWED By,--------------------------------- TE...... ------------- <br /> BUILDING PERMIT ISSUED-------- <br /> lill ­----------- <br /> Alterations apd/cm r cornmenclatio..... <br /> IZ- <br /> ............ .............. .....................------- ........ <br /> -----------_._.... --------------------- <br /> ------------------------------------------------------ <br /> .............. ........... <br /> .......... .............. <br /> i ------------ ---------- <br /> ............................ .......119-------- ------------------­...... --- ----- ......----------------_ -------- <br /> ill, <br /> FINAL INSPECTION BY------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT 205 West 91h Street <br /> 130 South Am@ .*t 300 Woo Oak Sir$M 124 Sycamore Street <br /> Stockton,CoNfognia 11 Lodi,California Manteca,California Tracy,Colifemia <br /> ES 9 REVISED 8-59 2M 5-62 ATLAS <br />