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291 , <br /> APPLICATION Applicant's Name MAS S MFii II)ANI✓V l Assessor's Parcel No. <br /> d <br /> ,, for Contractor 'J Authorized Agent <br /> WA C t; of AY book C2'11>� <br /> APPROVAL <br /> Address ///-r�y�y t,e� / <br /> for Cit 5 �'Ck7-6A.J 4. 5q5-210 s` �(�J�j page / f <br /> Cityphone py l�� I � ,r — parcel <br /> CONSTRUCTION Owner's Name / K 1 [�.+ ,r+ /CJ I� /� ( rll4AI AJI V l _ Subd. <br /> in Address �1l 1 L 4 <br /> San Joaquin County city .77-0 0 KT70N 04. '1'. unit# <br /> ��/G1 ����`- ��,�,� <br /> phone block# <br /> Precise location of.property � E7LOT N w l G► [�} �j�� lot# <br /> 7 -4/44! __ G1) r 1-r' R 04 D ` Yes No <br /> �S 6 $� �?f7 f�. )QO) A sewers O C�7 <br /> Structure address ri � ) water system 0 <br /> Proposed use of structure(s) R-�EN CF-' , drainage system_� 0. <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 t� <br /> (c) The locations of all existing building and distances to lot lines (h) Levees, with the crown shown e" <br /> (d) The locations of existing and proposed septic tanks and wells (i) WITH DOTTED LINES, THE PROPOSED STRUCTURE or ADDITION <br /> t North- <br /> � .. t <br /> si <br /> 3 <br /> q .y <br /> Y <br /> .ori <br /> IJ <br /> . <br /> �— <br /> C <br /> E <br /> A �.e <br /> f <br /> a. �' ' <br /> g <br /> z <br /> h <br /> t � <br /> i <br /> L} 9 <br /> t <br /> r <br /> 3 p �{ <br /> t <br /> ., <br /> _ <br /> Applicant that <br /> tth ProPeYrtY for which_the APPROVAL is sought_is described as above�and that a,I- existingstructures on the propeF <br /> ty are <br /> shown-on above-plot P -4,t4 so' , <br /> Date 4. / ,�'`. . !d8 k Applicant's Signature tel.✓: .f � � r <br /> ,,r -.+-- <br /> • PLANNING DEPT. 1810 E. Hazelton Avenue • PUBLIC WORKS DEPT. 1810 E. Hazelton Ave'. • LOCAL HEALTH DISTRICTG-�te- <br /> 1. Property meets zoning requirements for both 1. PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction /J r A. Encroachment Permit required Ef]- —1601 E. Hazelton Avenue <br /> Yes 0 No 0 Zone �' w' E/ a B. Surface drainage established'as shown 0 1. PROPOSAL APPROVED SUBJECT TO: <br /> 2. SPECIAL CONDITIONS C: Fees A. Obtaining sanitation permit �� ' <br /> A. School district fee 0 ,;�a. Connection Fee B. Obtain well/pump permit— <br /> B. <br /> ermit B, Floodway as shown 0 b. Buy-in-fee 0 C. Change noted <br /> C. Flood fringe 0 2. REMARKS4-,-,)t nr A PA-A!0 6 4 --,2, PROPOSAL DENIED <br /> D. Noise impact <br /> 3. PARCEL MAP NO. 0 15 " C..� r 3. REMARKS �t � <br /> 4. REMARKS � '� /I lrf.,.f,_.by k4-) f�16a "t::ts ���� <br /> � <br /> date.,9 <br /> „ t �Ij date /�� e1� by�i�f/ cl�tn. `�'8 <br /> -�-^ FL0OD�CONTROL: date �+ <br /> date edr-lt�ia, byr by. ® BL. iNsa. ia�i�ei I <br />