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7r,3D6/ <br /> -�M <br /> Assessor's Parcel No. <br /> APPLICATION Applicant's Name <br /> for p Contracts p Authorized Agent book ; <br /> i APPROVAL ._Address �"�" •� ^' <br /> page ` ti <br /> for City phone — I <br /> Parcel <br /> CONSTRUCTION owner's Name_ %cta _ '�'� subd. <br /> in Address. .J�/�� G`f/C r •�c�� s/s— <br /> Son Joaquin Count ! / — unit. <br /> .i q r City �.. -�'[�i�, >^.'s►J,7 �- .tom"y --phone <br /> Precise location of property lot e <br /> "i <br /> Yes No <br /> 8l�c4Z l C.-rw 1 S"[11 �y sewers p LSs1 <br /> -£ Structure address water system <br /> Proposed use of structure($)- �� %' "i>4yilli/!/ frr,f, t�✓ drainage system_ <br /> i DRAW — (aLocation of minimum sewage disposal area to septic tank and leach lines <br /> (a)The lot or parcel involved,showing shape i dimension (f)Irrigation or drainages ditches,waterways and drainage ponding groes A� <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 sail distances to lot lines (h)Levees,with the crown shown <br /> (d)The locations of existing and proposed septic tanks and wells (1)WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> Nort - <br /> - y <br /> j tt <br /> �. __. . <br /> _ <br /> } <br /> _.. . <br /> Yr ..� <br /> i <br /> op <br /> . OI <br /> a <br /> i <br /> t <br /> - j <br /> i • <br /> Applicant certifies that the property for which NM 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 -=— - L✓"7 Applicant's Signature <br /> •PLANNING DEPT. 1810 E.Hazelton Avenue •PUBLIC WORKS DEPT. 1810 E.Hazelton Ave, a LOCAL HEALTH DISTRICT <br /> .Propel— rty meets zoning requirements for both I.PROPOSAL APPROVED SUBJECT Tp1 ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permit rsqulred L_ 1601 E.Hazelton Avenue <br /> B. Surface drainage established as shown <br /> Yea [�No p Zone p 1,PROPOSAL APPROVED SUBJECT T0: <br /> 2.SPECIAL CONDITIONS C.Fees A.Obtaining sanitation permit [� <br /> A.School district fee t Pci'( a. Connection Fee p 8.Obtain well/pump permit <br /> B. Floodway as shown p b. Buri i-1 C.Change noted p <br /> C.Flood fringe p AR <br /> 2.REMKS 1 I S 2,PROPOSAL DENIED p <br /> D.Noise impact <br /> 3.PARCEL ISP N0. n v I 3.REMARKS <br /> 4.R RKS ra W date by s:' <br /> ✓ date /222-.°' G%/.�-�:.•-- <br /> u !r 5 f NV FLOOD CONTROL:daa <br /> dateby by +^ RLDG.INSP. 14(3/761 <br />