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SCANNED <br /> APPLICATION Applicants Name t-Fn - �•� � I '� "il a'ii<" Lr <br /> Assessor's Parcel No. <br /> for Contractor I_I Authorized Agent book <br /> APPROVAL Address — ,/r. •a, r_ - ''J <br /> page <br /> for City J ' 4 "- phone <br /> i <br /> parcel Isar <br /> CONSTRUCTION Owner's Name �"/� - ' - soba. —_ <br /> in Address �, <br /> San Joaquin County .� _Y y., - block o <br /> PreciSe location of rucperty� -j - - 'I T = <br /> 0 of e _ <br /> -/ ewers <br /> Yes No <br /> [I <br /> Structure address — -- water system._i. <br /> �:a.p y!= drainage system— <br /> Proposed use of structure(s) _ -- <br /> DRAW (e)Location of minimum sewage disposal area for septic tank and leach lines <br /> (a) The lot or parcel involved,showing shape g dimensions (t) Irrigation or drainages ditches.waterways and drainage pending areas <br /> (b) AputtriR streets and other right-of-way and/or easements (g)Location of existing and proposed driveways and encroachments <br /> (c)The locations W all existing building and distances to lot lines (h)Levees,with the crown shown <br /> (d)The locations of existing and proposed septic tanks and wells (i)WITH DOTTED LINES.THE PROPOSED STRUCTURE or ADDITION <br /> - NL orlh-� <br /> BIB Ex.Pa w`y <br /> I� <br /> "CN <br /> J <br /> a x 10 `J <br /> t `J is, y O <br /> o <br /> sa N d N <br /> 5 ex W <br /> ex <br /> em <br /> 1, H d w C .� <br /> a v ? i <br /> x <br /> E u v !N <br /> v] <br /> 2 c] O W <br /> I� APpma.6nr<1-v <br /> Applicant corollas that the property for which the APPROVAL is sought is described as above and that all existing structures on the property are <br /> shown on the above plot plan. <br /> Date S - Tc( !h� Applicant's Signatures r ef = i <br /> .PLANNING DIV. 1810 E.Hazelton Avenue •PUBLIC WORKS DEPT. 1810 E.Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> 1.Property meets zoning requirements for both 1.PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permit required;Zj t L7r�Jj 1601 E.Hazelton Avenue <br /> Yes No I Zane -y`/-�� B, Surface drainage established as shown(J 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SPECIAL CONDITIONS C. Fees A.Obtaining sanitation permit I <br /> A.School distrlcl fee a. Connection Fee -I B.Obtain well pump permll �; <br /> S. Floedway as shown b. Buy-mcfee — :_I C.Change noted [_ <br /> C. Flood fringe 1 2.REMAB Ks.N n'O / I' 2.PROPOSAL DENIED <br /> D.Noise impact _ y <br /> 3.PARCEL MAP NO 3.REMARKS - Lu <br /> dale,. <br /> q.RE.MARKS� t dole�y -._by <br /> l'_ r <br /> � FLOOD CONTROL: date -- <br /> date �-bY -- by v ale,ea <br /> �1 Y <br />