Laserfiche WebLink
FOR OFFICE USE: <br /> -----------------"----- ----------..__.__.-..--__--_ APPLICATION FOR SANITATION PERMIT Permit No. ...� .l1...3..... <br /> rft <br /> ------ -------- 7 ` <br /> ------------------------------------ <br /> (Complete in Duplicate) <br /> ------ This Permit Expires 1 Year From Date Issued Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described, <br /> This application is made in compliance with County Ord-infante No. 549. <br /> JOB ADDRESS AND LOCATION-----------•----•-------------6TH •-�f9 `S a t ..-S.�I( -1 '�- �`' - <br /> Owner's Name:---------------- <br /> Address----------------------­--------------- _ <br /> Contra" <br /> ctor`s Name.-."-... .... nz.L2<..- %�,,,� ... _- Phone----•---•--•----•----••---------•-- <br /> Installation will serve: Residence,® Apartment House ❑ •mmercial ❑ Trailer Court ❑ Motel [] Other <br /> Number of living units: ___- Number of bedroo s _ - umber of baths Lot size <br /> Water Supply: Public system ❑ Community:system rivate I_ Depth to Water Table ------.- ft. <br /> Character of soil to a depth of 3 feet: Sand n Gravel f-Sand Loam Clay Loam Clay P ❑y ❑ y ❑ y ❑ y ❑ Adobes. Hardpan ❑ <br /> Previous Application Made: {If yes,date------------------ -} Not New Construction: Yes4 No ❑ FHA/VA: Yes ❑ No�A4 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 280 feet.) <br /> f {`/s�/ <br /> Septic Tank: Distance from nearest well---1_0.__#Distance from fou ation---1--S.n' �.Materlal__-_L'�/I✓ <br /> No. of compartments q a Li uid de th__--"_ "" <br /> P s Size -_-- r 9 I? r� Capacity---- <br /> - <br /> .Disposal Field: Distance from nearest well...�,r(._.;/o_1-Distance from foundation-----,jQ. ----Distance to nearest lot line--,,--­-------- <br /> Number of lines----------------- Depth-of fi <br /> Len ___.Wdhf <br /> itotrench._.-rte r_:__.-- � <br /> Length of each line <br /> Type of filtertmaterial----479Ar __ epolter,material'.-'—:_-----Total` <br /> r , __. g ill -----------=- <br /> y <br /> Seepage Pit: Distanceto n+are�stwel *r - ---,-• D �tea from foundation <br /> pis" <br /> etot ­-nearest lot line-___ _ -_�_ <br /> --._mbeof P - Lining Size: =r- - D { - '❑ \ <br /> P . <br /> Cesspool: Distance. from,ne'areO well----._-__----.-•Distance from foundation ----------------- material--------------------------------------" <br /> ❑ <br /> r Size: Dltr .-- t _ Depth M- - ..� -_ <br /> --------Liquid Capacity'--- ------------------gals. <br /> o Q`" <br /> APrivy' Distance from nearest well___ ` nce e --_____________ " __- -- ___-'--.- istarr - -------------- --------•--------------- <br /> Distance to nearest lot lin" r <br /> Remodeling and/or repairing (describe ' -- - ___ ----------•----•-----•-------••---------------- <br /> ---------------•---•----------••-------------------------------------------- -•-------------- ------------------ <br /> --------------------------------•-----------------------•----------...-•-•------------------------.-.__.' --- -•----------------------- <br /> -----------------------------------------------------••-"'"-----'•-_-_-_-•`-_---_••"---'_---'---_•----------_---_-..: "----"----------•-----------------------•--------------------------------------=--------------------- �# <br /> 1 hereby certify that I have prepared this application and thatlhe work will.be done in"accordance with San Joaquin County <br /> ordinances, State.laws,.,anA rules and re ations of the San Joaquin Local Health'Districi <br /> (SFgfled)....y`-\---------"-- -------- ------ ------------------- -------=--------------------------------------------------:--------------------^--------,.(Owner and/or,COntraG#Orl <br /> ---•------•-_f-_/------.»------------------------------------"- -By:-- � =-} <br /> - ------------------------------------------•------------{Title) -=- Y <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). eft <br /> A <br /> FOR DEPARTM T SE ONLY <br /> APPLICATION ACCEPTED. BY----. ._ ----- DATE ,-- <br /> ------- - ---------------------------- <br /> - -------- -- --- <br /> REVIEWED BY----------------- -�------ -- ---�--- <br /> - - -- --------------------------------------------------------- DATE <br /> BUILDING PERMIT ISSUED---------------------'---------------------------- --------------------` ----------------. DATE.-----_------------ <br /> Alterations and/or recommendations':-------------------------------- -------------------------------•-•-----------------------------------=................ <br /> .._.__... <br /> •----------•--------•-- -•-------------------------------------- ----- <br /> u _ <br /> 1 � ��� <br /> ---•--------------------------------------- -----------------------------------• ------- ------------------------------------------------------------ <br /> FINAL INSPECTION BY:.--lo. .._ / ('� Date-----1- - �j-Za - / xS <br /> SAN JOAQUIN-LOCAL HEV,�LTH DISTRICT ' <br /> 130 South American Street 300 West Oak Street 124 Sycamore Street 205 Wat 9th Street a <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> �rN.6mr0 8.69 i,F.r O.2M 6.60 <br /> �•?4 7 <br />