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aeM• «—� ,4�+ <br /> z <br /> A DAN A I✓r`1 V I S Assessor's Parcel No.._�.- <br /> APPLICATION DDlicant's Name n�5 <br /> for XContractor Q)Authorized Agent book oC <br /> APPROVAL Address 9:2. �i 1 1 r+hv r Qd page Q�n <br /> for City E 5,C. \ CI 3 L l7 phone D3C6-?(`t 1 - parcel ,°l <br /> CONSTRUCTION Owner's Name S�+ Q) l7A N A. DAVIS _ <br /> subd. <br /> in Address 9 2 01 1 1 A rA-V.y r Q8 _ <br /> Son Joaquin County unit o <br /> City i±t�5 C-`G 0� C phone block n _ <br /> Precise location of proper tyN 15 Nr^4' vd- 33 w y-r\L q lot x <br /> Yes No <br /> sewers <br /> Structure address 5 ( � w [] <br /> n water system <br /> Proposed use of structure(s) _ _t"tG S���G� She drainage system_ED <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 Y <br /> ° )o W 350North• <br /> 8.0 Fwar r,: <br /> t <br /> _ <br /> rid <br /> L of <br /> n <br /> o� <br /> A�F <br /> S <br /> P .G7 AC. <br /> I _ <br /> Approxi Soak I ( - OC7 <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 Applicant's Signature - a <br /> •PLANNING DIV. 1810 E.Hazelton Avenue •PUBLIC WORKS DEPT. 1810 E.Hazelton Ave. B LOCAL HEALTH DISTRICT ,.. <br /> } 1.Property meets zoning requirements far both 1.PROPOSAL APPROVED SUBJECZ.TO: ENVIRONMENTAL HEALTH 61VISION I - <br /> } use and con uct(on A. Encroachment Permit required�xL-,V 1601 E.Hazelton Avenue <br /> Yes No Zon� B. Surface drainage established as shown 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SPECIAL COND TI IONS C. Fees A.Obtaining sanitation permit- <br /> A. <br /> ermit A.School district fee [] a. Connection Fee L.] B.Obtain well/pump permit [] <br /> B. Floodway as shown [] b. Buy' -fee C.Change noted [� <br /> 1 C.Flood fringe � 2.REMARKS 2.PROPOSAL DENIED <br /> C7 <br /> D.Noise Impact 3.REMARKS ✓v' <br /> 3.PARCEL MAP N J <br /> date <br /> 4.REn'A KS date 1 ,-1lzj'C by yJnip <br /> FLOOD CONTROL:date �C✓�s` <br /> ® BLOC.INSP. 1♦ e <br /> . (8/ s <br /> date by <br /> ,�4/' by <br /> I <br /> Pic - +� <br />