18126 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE-./,�f.�c I -- ---�----- �--- ---�-------= �� 'R _.Z ...... { t_I ------------------------ _� y � - APPLICATION FOR SANITATION PERMIT Permit No. f----------------------------------°--- (Complete in Duplicate) Date Issued _--- This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and stall the work herein described. This application is made in compliance with County Ordinance No. 549. DI j i JOB ADDRESS A LOCATION_____- t<_K 'v�= -•----Z1A1Pdr#__A4 -- fir/ {1 Owner's Name--- d- ---------- Phone-- ��`-/e ••------�]-r�'7 -Leal-1v------- --------- ---------------------- Address----... .9 ....----47�---- ---------------------------------------------------------• ---------- �Y Contractor's Name------ � - -- ,�Id -+ --- ------------------------------------•--- Phone. 4JI16 - -9-7 i Installation will serve: Residence ]@ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __f---- Number of bedrooms —3-_ Number of baths __Z__ Lot size ------ ---- �- -------------- Water Supply: Public. system ❑ Community system .❑ Private Ex Depth to Water Table 4p-- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ZI Hardpan ❑ Previous Application Made: (!f yes,date--------------------1 No ® New Construction: Yes [f No ❑ FHA/VA: Yes ❑ No TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) �D- T-.Mat ria! PR Septic Tank: Distance from nearest well�Q.-------Distance from fou dation-- - - Liquid depth d 9•-� p Y No. of compartments---- ---------- Size- ' x�r Disposal Field: Distance from nearest well 60 from foundation.- 0 Distance to nearest lot li eta. I Number of lines-------�--------d--------------Length of each line----�,'.�- -.-----Width of trench..-.. ---------- & --- -------- Type of filter material-S�i�-� &...Depth of filter material ----------Total length----__l. Q-_- .� Seepage Pit: Distance to nearest well--��--.--_--Distance ff om foundation--- -_----� -------- A ----- C� �Q .--.__.Distant to nearest lot line---.- ----- tee' ® Number of•pits_----Z-----------Lining material,/i�B /f`__.Size: Diameter------ --------- Cesspool: Distance from nearest well-----------------Distance from foundation-----.----.----.--- Lining material---------------------------------- ❑ Size: Diameter--------------------- - --------------Depth_..--------------------------- ---------------------Liquid Capacity----------------------------gals. Privy: Distance from nearest well----------------------=----------------------'---Distance from nearest building----.-----._--------------._--..---------- ❑ Distance to nearest lot line-------------------------- ----------------------------- ------------------------------- Remodeling and/or repairing (describe:-____ .. z V_.S-7,'..42.-----R�X-�/-----:�5y__°Z Arl---------------------------------------------- C . of -----------------------•----------- ---- ------------------------------•-------------------------------------------------------------------------------------------------- ------------------------- I here-by certify that] have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, S+ate laws, and rules and regulations of the San Joaquin Local Health District. :PAi x Owner and/or Contractor) . -J�-I...P- * ' =-------------- f (Signed)- L -�°------------ ------ --- - ------ ---------- ------------------(Title)-------- --- (Plot plan, showing size of lot, location of system in re ion to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY ll APPLICATION ACCEPT>"D BY �it ---- ----------- / .: DATE f L REVIEWEDBY--------------------------------------- ---------------- DATE------------------------------------------------------------- BUILDINGPERMIT ISSUED----------------------------------------------------------------- ---------- -----------------4------- DATE.---------------------------------p----- ---------------- --- f Alterations and/or recommendations:--------/-'�-�'L.��=---�-/�=---------- -----, �-c-�.v----��------------'---` l�----------------------------------------••---------------------------------------------------------- ------------ --•- ---------------------------------------------- -------------------------------------------------------------------- ------.-- ---------------------------------------------------------------------------------------------------- ---------------- -------------- ---------------------------------------------------------------------- / rAN Date--- FINAL INSPECTION BY------------- ----- -- OAQUIN LOCAL HEALTH DISTRICT 1601 E.Hoselton Ave. ak Street 124 Sycamore Street 205 West 9th Street k Stockton,California Lodi,California Manteca,California Tracy,California E5 9 iEEVISEo 8-59 3M 3-'63 F.P.CC. 9k