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NYY i <br /> - Assessor's Parcel No..— <br /> APPLICATION <br /> APPLICATION ApplicaM's'Name — - <br /> •. �� Ly9 Contractor [� Authorized A;;ent tools <br /> for <br /> APPOVAL Address pee <br /> "lot City _ phs parcel <br /> CONSTRUCTION Owner's Name <br /> r i <br /> � in Address '� - _. <br /> ,mit It <br /> San Joaquin County .City phone block <br /> I lot a <br /> Precise location of property I! —" os 1a <br /> wat Q <br /> Structure address < < .� drainage systemPA Alm, <br /> Q <br /> Proposed use of structure(s) <br /> DRAW i�. (e) Location of Yninimum sawage disposal ansa for septic tank and leach lines <br /> pond Ing areas <br /> (a) The lot or parcel involved, showing shape &dimenalans (t) Irrigation or c9ralnaEes dltctres,wa� �andaencroachments <br /> (b) Abiittinli streets and other right-of-w'ay and/or easements (g)Location of r�xisiw�watIng and proposed ys <br /> (c)The locations of all existing building and distances to lot lines (h)Levees, with the crowns shown QED�MRE or ADDITIQN <br /> [d! TM lacatiass d existN4 and proposed septic tanks and walls (1) WITH DOM-0 LINES, L <br /> , <br /> North <br /> /- qtlt <br /> _ <br /> + <br /> 1. 6 4 - r i <br /> a t_ y rr <br /> �,..Y <br /> 1 <br /> �T <br /> 4. <br /> kt - -t <br /> .:_ i -1_ s- <br /> _4518I I <br /> 40 <br /> 4+1 t <br /> 0. <br /> , <br /> { l: �}-� j <br /> ov <br /> Applicant certlfFes that the property for Ish the Af'PtfOYAL„is sot�ht is dsrscrlbed as above and that all ex 161 svgctins.on the.pragerty an_, r,. <br /> I shaven nn'the aabove Plot plan. <br /> f Date_ S/ Z- I g / I .. Appllcani's SiQnatun <br /> VIII • PLANNING DEPT. 1810,E'. Hazelton Avenue i. PUBLIC WORKS DEPT-18 E Hazelton Ave. ° + LOCAL HEALTH DISTRICT <br /> Property meets zoning requirements for both T-PROPOSAL APPROVED SUBJECT TO: ” <br /> ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A: Encroachment.Permit requlrehf [�. 1601 E. Hazelton Avenue . <br /> Yes Q No M Zone .0. Surface drainage established as shown Q 1:PROPOSAL.APPROVED SUBJECT TO: <br /> {E 2. SPECIAL CONDITIONS., C. Fear 'A._a►telnlhiM_sanitation.per' It <br /> A,School district fee I� . Q a..Connection Fee 8 'Obtain well/pump permit 0 <br /> B; Floodway as shown �. <br /> b. Buy In�ee Q C:Chsrh�e noted:_ <br /> C. Flood fringe © `2.REMARKS - --:-.� 2: PROPOSAL DENIED D <br /> D.Noise impact C-1 <br /> _ 3.REMARKS <br /> S. PARCEL MAP NO. <br /> date ��—by -- -= --- <br /> d.REMAFRKS dab . <br /> I�.. FLOOD CONTROL -date r <br /> it hB s4 <br /> data by' ----- r ?. <br /> Ly no' iHar. ha 11i74u <br /> r - <br />