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Plot Plan Application <br />SAN JOAQUIN COUNTY DEPARTMENT OF PLANNING AND BUILDING INSPECTION <br />Owner's Name <br />Address <br />City <br />Applicant's Name <br />Address. <br />City <br />Precise location of property <br />Structure address <br />Proposed use of structure(s) <br />i <br />Zip <br />0 Contractor 0 Owner <br />Zip <br />phone <br />phone <br />A.P.N. _ <br />Subd. name <br />map it <br />bl/lot n <br />Census Tr., <br />Setback: <br />front <br />Hazelton Avenue <br />1. Property meets zoning requirements for both <br />left <br />1601 E. Hazelton Avenue <br />Yes - F-1 No 0 Zone <br />1. PROPOSAL APPROVED SUBJECT TO: <br />2. SPECIAL CONDITIONS <br />right <br />A. School district fee <br />B. Obtain well/pump permit <br />rear <br />C. Change noted <br />C. Flood fringe <br />0 <br />Yes <br />No <br />sewers <br />0 <br />0 <br />water system — <br />O <br />0 <br />drainage system _ <br />0 <br />O <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 <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 <br />• PLANNING DIV. 1810 E. <br />Hazelton Avenue <br />1. Property meets zoning requirements for both <br />use and construction <br />1601 E. Hazelton Avenue <br />Yes - F-1 No 0 Zone <br />1. PROPOSAL APPROVED SUBJECT TO: <br />2. SPECIAL CONDITIONS <br />A. Obtaining sanitation permit <br />A. School district fee <br />B. Obtain well/pump permit <br />B. Floodway as shown <br />C. Change noted <br />C. Flood fringe <br />0 <br />D. Noise impact <br />0 <br />3. PARCEL MAP NO. <br />4. REMARKS <br />Applicant's Signature <br />PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. <br />1. PROPOSAL APPROVED SUBJECT TO: <br />A. Encroachment Permit required 0 <br />B. Surface drainage established as shown 0 <br />C. Fees <br />a. Connection Fee- <br />b. <br />ee b. Buy -in -fee 0 <br />2. REMARKS <br />date by <br />FLOOD CONTROL: date <br />LOCAL HEALTH DISTRICT <br />ENVIRONMENTAL HEALTH DIVISION <br />1601 E. Hazelton Avenue <br />1. PROPOSAL APPROVED SUBJECT TO: <br />A. Obtaining sanitation permit <br />0 <br />B. Obtain well/pump permit <br />0 <br />C. Change noted <br />0 <br />2. PROPOSAL DENIED <br />0 <br />3. REMARKS <br />date by <br />G) BLDG. INSP. 14 (8/83 <br />