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K <br /> S612-6 <br /> t%llan Application <br /> ~ tJAOUIN COUNTY DEPARTMENT OF PLANNING AND BUILDING INSPECTION <br /> A.P.N. sift (_ <br /> Owner's Name Su <br /> _ Address atQ33—nt_5=� ,_ d s„bdnam° <br /> ... map X— <br /> Z. <br /> City—�Si__1LInit hl _...� Zip ( SZ�� <br /> 4.1 phone jL-1177 bllio!R <br /> . —`-- <br /> Applicant's Name Census Tr. <br /> S <br /> Contractor- []Owner Setback; <br /> i <br /> Address front � <br /> me City Ziphone left—- 1 U <br /> p right �4 <br /> Precise location of rt a w,JC 1:%. --_T <br /> properly— �7 <br /> rear 3() <br /> - _ Yes No <br /> Structure address sewers 0 &n' <br /> water system— )F1 <br /> Proposed use of structure(s) drainage system_Ej <br /> F.. DRAW fel Location 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 ponding areas <br /> _a (b) Abutting streets and other right-of-way and/or easements (g)Location of ex!at Ing and proposed driveways and encroachments <br /> (cl The locations of all existing building and distances to lot lines (h)levees,with the crown shown <br /> Id) The locations of existing and proposed septic tanks and wells (i)WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> O <br /> J — <br /> Applicant certifies that the property for which the APPROVAL is sought is de }i as a ove and that all existsn tructures on the .3 rte are` <br />'+ i» shown on the above plot plan. <br />,1 Date <br /> .� Appfioant's Signature <br /> 5 .PLANNING Div. IS10 E.Hazelton Avenue .PUBLIC WORKS DEPT. 1810 E.Hazel n Ave. .LOCAL HEALTH DISTRICT <br /> i•_ .Prouty meets zoning requirements for troth 1.PROPOSAL APPROVED SUBJECT <br /> ^,'t_}ny, , ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A, Encroachment Permit required i,�. [� 1601 E.H�¢elton Avenue <br /> Yes No fl Zone B, Surface drainage established as shown 1.PROPOSAL APPROVED SUBJECT TO: <br /> ��yy''�� <br /> 2.SPECTRE CONOITiON$ <br /> 3'S3: (/�rfJFv C. Foes A.Obtaining <br /> rti A,School tlisirict feeu ,.T t/ ng sanitation permit <br /> i� a. Connection Fee © B.Obtain well/pump <br /> . S. Floodway as shown b B� permit <br /> C.Flood fringe {� 2.REMARKS Inde - ` [] C.Change Hated <br /> # D.Noise impact I �---- 2.PROPOSAL DENIE <br /> 3.PARCEL MAP N0. - 0 41 3.REMARKS <br /> ,fa l 4.REMARKS fl ti date , by <br /> -n- <br /> FLOOD <br /> .M <br /> FLOOD CON OL: date t°�' a$� y <br /> - date(1by -J b Dc. INSP. ,•y to/@$r <br /> knt Plan Valid Until 0 y :?0 G J(��'��15 <br /> s, <br /> .' 5G i A'dt2'fH I':C2,11 N[ l�� LIAt i �` <br />