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• r -vr ^' s'y,:. �_:;�E, +Ft'rk.� Prv� <br /> �FA <br /> Vw4 Assessor's Parcel No.A I icant's'Name � ck, <br /> L1CATi0N PP ,3 Contractor Authorized Agent book �qforPROVAL Address Dtzi �— 7-4' page_Z-50 <br /> for <br /> City i A 4' phone .—0(/7.7 parcel 1 <br /> r CONSTRUCTION Owner's Name Sum' -sr��t�r � <br /> M in Address <br /> unit,' <br /> San Joaquin County City — phone block <br /> x Precise location of property ai`S � SdU T�� �1, CSG � lot>x �8 <br /> Yes No <br /> y,`„�'O U)6SY 01-- om T +�s sewers 0 <br /> r <br /> r - water system <br /> tStructure LJdress ` drainage system <br />{ P•-posed use of structure(s) <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 /> I North <br /> .. <br /> - �-...�_ moi- E�� -F-�-•• <br /> .. <br /> ; [ <br /> -4— <br /> It! <br /> 4, i l t- <br /> - r <br /> a - <br /> E <br /> E <br /> 3 <br /> i <br /> m:711 <br /> • �`-?— _-�-_a_I ° 1 i-�...--1 z7"-+���il�l I E� --SEE--•--'—,.e�.t�.s.,., <br /> 4. <br /> E e.li.t .. - I self, - <br /> 1 _ _ i <br /> E ' <br /> I ^ <br /> i f }— _ <br /> , <br /> i E I <br /> 4- <br /> -7- <br /> L-4 <br /> 33 .---- <br /> E <br /> ji­ <br /> Ll <br /> i - <br /> 1 <br /> .. <br /> .... <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 /> 4I.An1» ,.a plicant'5 — <br /> • A Signature <br /> Nv . PLANNING DEPT.'1810 E. Hazelton Avenue • PUBLIC WORKS DEPT- 1810 E. Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> 1: Property meets zoning requirements for both I. PROPOSAL APPROVED SUBJECT TO: , -ENVIRONMENTAt_ HEALTH DIVISION <br /> use and construction �.. A. Encroachment Permit required 1601 E. Hazelton Avenue <br /> Yes +41 No 0 Zone 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 0 B. Obtain well/pump permit <br /> B. Floodway as shown b- Buy-in-fee C. Change noted 0 <br /> C. Flood fringe [] 2. REMARKS + ` � r� 2. PROPOSAL DENIED [� <br /> D. Noise impact 0 .�--� : 3. REMARKS <br /> tt 3. PARCEL MAP N0. date # `I by �— <br /> 4. REMARKS IF SSI p�>� date 5 Y _ <br /> ki ��SY^iClvJ?J FLOOD CONTROL: date <br /> date%.c r i S-F by W by BLDG. f1�5P. r/7 <br /> r <br />