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L <br /> 7W <br /> Assessor's Parcel NO.._� <br /> APPLICATION Applicant's Name j�Authorized Agent book--�-- <br /> �]Cvnuactor <br /> for page_-----�---- <br /> APPROVAL Address 565-6 <br /> phone��— parcel .w+"�� <br /> for City <br /> — Surd.�--��-- <br /> CONSTRUCTION owner's Name qu <br /> unit u <br /> in Address <br /> Son Joaquin County City hone block+ - <br /> Q r lot p_�—�— <br /> • Precise location of property O Yes No <br /> sewers C_] <br /> water system,© C- <br /> Structure address drainage system— ._ <br /> Proposed use of structure(s) <br /> AW (e}Lacatian of minimum sewage disposal area for Septic tank and leach lines <br /> (a)The lot or parcel involved,showing shape&dimensions (f) Irrigation or drainages ditches,waterways and drainage parading areas <br /> ;bl Ahe lot streets and other right-of-way and/or easements 12}Location of existing and proposed driveways and encroachments <br /> (c)The locations of all existing building and distances to lo[Imes. (h)Levees,with the NES,rown shown E or ADDITION <br /> (dl The locations of existing and proposed septic tanks and wells {i)WITH DOTTED LINES,THE PROPOSED STRUCTUR <br /> N <br /> WPhiozP"s ptt,iL 0in1 <br /> ,ter <br /> _ r <br /> r <br /> � ro�ot� r <br /> ri <br /> — <br /> ( g Q�t:C- <br /> Sys'ut^+ <br /> • GI <br /> Q <br /> Ap icant ter that the property for which the APPROVAL is sough is dess�¢]ribed as above and that all existing struetwes an the property are - <br /> ghown on the above plot plan. (_Lk <br /> I r-^ �; -r". . <br /> Applicant's Signatu'r�� <br /> DateHEALTH 03 <br /> x .PLANNING DIV. 1810 E.Haze Ron Avenue .PUBLIC WORKS DEPT- 1910 E.Hazelton Ave. •ENVIRUNMENTALDHEALTH DIVISION <br /> 1.PROPOSAL.APPROVED SUBJECT T0: 1601 E.Hazelton Avenue <br /> 1.Property meets zoning tequirernents far both A Encroachment Permit require <br /> _ use and construction <br /> Yes f� No � Zone B. Surface drainage established as shown 1-PROPOSAL APPROVED SUBJECT T0: <br /> C. Fees A.Obtaining sanitation permit <br /> ` 2.SPECIAL CONDIT]DNS B.Obtain well/pump permit- <br /> A. <br /> ermit A.School district fee ,] a. Connection Fee C.Change noted <br /> b. Buyin•fae <br /> B. Floodway as Shown 2 REMARW ��'`' --�-�r../`-. 2,PROPOSAL DENIED- <br /> C. <br /> ENIED C.Flood fringe 3.REMARHS .. .:. T�`i0 <br /> D.Noise impact _ <br /> 3.PARCEL MAP NO. <br /> 4.REMARKS -- dat�-,- k, <br /> FLOOD CONTROL: date --�--- ti,-..- �yaa, ..IF. 14 s.iaa <br /> datlil'l/fes.—ty <br />