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Plot Plan Application <br /> SAN JOAQUIN COUNTY DEPARTMENT OF PLANNING AND BUILDING INSPECTION r-r <br /> Owner's Name Sut3d.name <br /> Address i <br /> man <br /> City Zip phone l r bl;'lot <br /> Applicant's Name Census Tr- <br /> [j Contractor Owner Setback: <br /> Address L front _ <br /> 1 <br /> CityZip #� hone left_—___._� <br /> —T— p —,' <br /> right <br /> Precise location of property _ rear�'`� <br /> Yes No <br /> Structure address sewers EL; LN <br /> water system <br /> Proposed use of structure(s) r ,t drainage system_ _ �] <br /> DRAW (e) 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 /> (b) Abutting streets and other right-of-way and/or easements (g) Location of existing and proposed driveways and encroachments <br /> (c) The locations of 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 /> _ w.. <br /> r <br /> North <br /> > <br /> > <br /> t <br /> z ' <br /> i <br /> L <br /> fid+. <br /> -4 <br /> Cl � <br /> r , <br /> Cts <br /> {.._« <br /> k <br /> Applicant certifies 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 <br /> Applicant's Signature <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 1601 E, Hazelton Avenue <br /> Yes No 7_1 Zone B. Surface drainage established as shown 1. PROPOSAL APPROVED SUBJECT TO: <br /> 2. SPECIAL CONDITIONS C. Fees A. Obtaining sanitation permit <br /> A. School district fee _J <br /> L� a. Connection Fee B. Obtain wellpump permit <br /> B, Floodway as shown [� b. Buy-in-fee [_J C. Change noted <br /> C, Flood fringe <br /> `.., 2, REMARKS ' <br /> D. Noise impact 2. PROPOSAL DENIED <br /> �'y <br /> 3. PARCEL MAP NO- / 3. REMARKS <br /> 4. REMARKS date by <br /> FLOOD CONTROL: date date by <br /> date 6y by E3 BLDG. INSR. 14 i8/8s <br />