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i - <br /> APPLICATION Appl icant'S Name Assessor's Parcel No.. <br /> For 0 Contractor Authorized Agent book 7_ ��— <br /> I APPROVAL Address paw J <br /> i <br /> for City ------- _-. , phone , <br /> CONSTRUCTION Owner's Name zr—e.,.. Zf/ : 6 _ Su�arcel J y <br /> Cls <br /> in Address.. y/S� `-,) �d /_CF Z" <br /> Son Joaquin County 7•�''� unite i <br /> City phone block a <br /> Precise loc ion of proty �� _ •,.f.�... ;i/ ; ,:lf .�', r -f 1 <br /> �� lol p 1 <br /> 10;Z <br /> per_L,�-�1.'u.. .C_/ .. Ga �:�•. . •J: J w� Yes. No I <br /> sewers CI . <br /> - <br /> Structure address <br /> water system 0 <br /> Reposed use at structure(s)-......- I� �.6F7 drainage system—[i 1- <br /> DRAW (e)Location of minimum sewage disposal area for septic tank and leach lines ! <br /> .I (a)The lot or parcel Involved,showing shape&dimensions (f)Irrigation or drainages ditches,waterways and drainage ponding areas 1 <br /> (b) Abutting streets and other right-ot•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 /> - 1-_ -- �--�-'• - - ..pfd" -+ ._.. ' 1 <br /> 7-7 <br /> -4�ff- <br /> -Ll <br /> t , t <br /> I <br /> I T .»�.. <br /> I <br /> .^..J.....E ,..T.. .._ _ _.. <br /> .� I. T =3 STING D11r8r,L'� j <br /> Hi Bil1 ilrc�k-Onc9 <br /> 1 3:ee._.lal <br /> i <br /> i CZr�c-tom <br /> u <br /> . r _ <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. n <br /> f 1 <br /> Date <br /> lie Applicant's -'�r_rJ:..,r ,w, <br /> i .-PLANNING DIV, 1810 E.Hazelton Avenue a PUBLIC WORKS DEPT. 1810 E.Hazelton Ave. . LOCAL HEALTH DISTRICT <br /> T.Property—meets zoning requirements for both I.PROPOSAL APPROVED SU13JECTTC T�O':"".�. ENVIRONMENTAL HEALTH DIVISION - <br /> iuse and construction A. Encroachment Permit required�Z�P( 1601 E,Hazelton Avenue . <br /> Yes Zoned B. Surface drainage established as shown Lj 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SPECIAL CONDITIONS C. Fees A.Obtaining sanitation permit NJ <br /> A.School district fee O a. Connection Fee B.Obtain well/pump permit O <br /> -I B. Floodway as shown L_j b. Buy-I .ee_.___.,..,,_._._.—._-� C.Change noted 71 <br /> I C.Flood fringe © 2.REMARKS + f at ,.tom : 2.PROPOSAL DENIED [� <br /> 'i <br /> D.Noise impact O l� . + 3.REMARKS -D f <br /> t 3.PARCEL MAP N0. - r'- - - _ <br /> 4.REMARKS �1,�Ly/.L_ ,�T��.� date Li.��•�by !f =i.�, ,x.t - - <br /> i <br /> r, a.eFLOOD CONTROL:date date s by <br /> date 'C-bit by ® aLoa. 11 a- .a W" <br /> I <br />