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APPLICATION Applicant's N anal " Asseawr s Parce!Ifo ' <br /> for 1 Contractor I"...I t orized Agent kook <br /> AL Address.___ '--- '+�' _ pagtt=_.¢ __W_ <br /> APPROVAL <br /> {- for. City .=— __phone---- - parcel <br /> CONSTRUCTION Owner's Name Subd. tt - <br /> F Z, <br /> : <br /> in. Address — unit rt <br /> San Joaquin County City phone --- block u k <br /> Precise location of property lot+t <br /> Yes No <br /> r sewers f i <br /> Structure address j watousystem n C] <br /> drainsys <br /> age tem <br /> Proposed use of.structure(s) <br /> DRAW (e) Location of minimum sewagi-d,isposal area for.septic tank and`mach lima <br /> .(a) The lot or parcel involved, showing shape a dimensions (f) Irrigation or:drainages ditches, and drainage ponding seas <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 P. POSED STRUCTURE or ADDITION <br /> t <br /> psa , _I <br /> R <br /> Y <br /> , <br /> S <br /> t � <br /> .L. <br /> r <br /> fic 'J <br /> 4 <br /> i <br /> f I ti <br /> • _ , _ ! ;. s � �. wnF•M1. e.4.�1rr�_wu-u I w�..- —L.,r. .--.•.�.._ � .. . <br /> I <br /> t <br /> 3 , <br /> i <br /> Applicant cerirf les that the property for which the APPROVAL is sought is described as above and that all existing structures on the property <br /> 4RSh0wn.on thezabove p19t_p!2 <br /> ,. Date — Applicant's Signature- r <br /> • PLANNING DEPT. 1810 E. Hazelton Avenue . • PUBLIC WORKS DEPT. 1810 E. Hazelton Ave.." • LOCAL HEALTH DISTRICT <br /> i 1. Property meets zoning requirements for both. 1• PROPOSAL APPROVED !SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permit required 0 1601 E. Hazelton Avenue <br /> Yes L] No [_] Zone B. Surface drainage established as shown 1.-PROPOSAL APPROVED SUBJECT TO: <br /> 2. SPECIAL CONDITIONS C. f=ees A. Obtaining sanitation permit <br /> A. School district fee Q a. Connection Fee -- OB. Obtain well/pump permit <br /> B. Floodway as shown 0 b. Buy-in-fee C. Change noted [] <br /> C. Flood fringe 2. REMARKS 2. PROPOSAL DENIED [� <br /> D.Noise impact 3. REMARKS <br /> ,3. PARCEL MAP NO. date by <br /> 4.REMARKS <br /> date— by <br /> FLOOD CONTROL: date. <br /> date_by by f: ® OLVG- IN SP- I 1117 9) <br /> ,i. - - . <br />