Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
� <br />APPLICATION FOR SANITATION PERMIT <br />(Complete in Duplicate) <br />Permit No. No. z&.41--' <br />Oofo Issued _Applica-lion is hereby made to /����L' <br />o San Joaquin Local Health Disthcf for a permit to construct and install the Installation will -serve: ' <br />I This application is made in compliatice with County Ordinance No. 549. /-0 -3 WY & L 0 oe,,tf- Pic -0 A_J:� <br />JOB ADDRESS ANDJO <br />QATION --- ------------- oi-se - ------ 0 - - ----- �­3�4 <br />----------- <br />____ =, Ap___. ...,~, ,,,~..= [] Trailer,Co"" E] Motel LJ Otho, LJ <br />Number of living units: / ...... t' Number of bedrooms umber of baths J'' Lot size ' �� <br />Water Supply: Public system [] Community system []�-� Private- �+o Water' Table ~�-fi <br />Character of m@ to a depth of 3 feet: Gravel Sandy Loam E] Clay Loam E] Cl^oy ---- <br />- ---' <br />D Adobe Q�_Hordpan [] <br />Previous Application K4mde/ Yes R~<0 [] New Construction: Yes Q-~Nof-1 � <br />TYPE OF INSTALLATION AND SPECIFICATIONS: | <br />/No septic tank o,cesspool permitted if public sewer is available within 200fwe| | <br />� ^ '. <br />Septic Tank' Distance from nearest woU�`��Distance from foundation4y ......... <br />Material � <br />1 Disposal Field: Distance f ' well ��/ ----- -- Distance from foundation ------- 1_0 ...... .Distance to nearest lot <br />' " <br />Number of xn=` - ffLength of each |i&.40��_6ofAF trench <br />_' . ~~_------------- Total length °'~~` <br />� ' 'Distance' -- to nearest�-- —lll----'' Distance from `=��.......... Distance to na°rom, m* / <br />Num6u,ofp��-.�����-Uning mu+eri°L -Sizn: Oiomotec--.-�Gp-Doo�- <br />Cnopool: Distance frcm nearest well -_`---Distance from foundation --- ------ --- ----- Lining material --__ ' | <br />[] ' Size: D�mefoc��--'_''----Doot�-'''--''-_''—----------------- Liquid Capacity -'----� ' <br />p,�v Distance fnom n6un,,+wek---�-'----'----''—Dida^ca from nearest 6mU6�g------------------------------------ <br />D <br />'' ' <br />�� Distance to noo�*f|o+ |��----.-~=.-_—_------__-_--^—.--'-''-'-_.-''�� ------'' <br />Romo6a|ing and/or repairing (6o���e:'____,_,___�_____________.__________.________.____________ 1 <br />-----.'_____-'-'--�`-''-��''_--'---'-----_.''--''--'''_-.-_-'_--_-.. -- <br />�' | '' -'-----'------'-- <br />--''-'--'-'--''--'------r''-'''--'---''---'''-----------------_._-..--.-____________.__.. <br />'--'---''-_—''_''------_-_-''''-''-''-_''__.-'---'''--'-_.'-_-''-_-'---'---- . Y� <br />----------------- <br />.-Ih ^arecl this application and that the work will be done in accordance with San --- � <br />ordinances,^State laws,` <br />� <br />^ <br />�: `tidings, efc., can be place( dsize of lot.. I cat I 'n of s ern in rela+ion to W611s, bui e"tt'verse A�sidal_FOR DEPARTMENT USE ONLY <br />_ <br />APPLICATION ACCEPTED -'- —'-'----'''-'-----'-'--''---'' u^/ � <br />KB4EVvED BY ------------ <br />------------- ____________~______________�_____ / <br />8U|UJ N�� PERMIT ISSUED -_-'���.'''--''_-'-''-------''''-'--.''-- DATE''��iAlterations and/or recommendations: <br />--'-'---'--''----''-FIN L INSPECTIOA - ------- / D�a �e7l --- --- ---- <br />SAN JO UIN'LOCAL HEALTH DISTRIC130 Sout American Street 300 West Oak treat 132 Sycamore Sfreef 814 North "C" treatStockton, California Lodi, California Manteca, CaliforniaI Tracy, Cali arnia <br />c° -r 14"°^^`°"r" ` / / <br />