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Assessor's Paj <br /> No. <br /> APAppI icant's NamePLICATION <br /> �* Contractor Authorized Agent bookz—,9 <br /> ,9 <br /> for '>U 111 cox �r page Z'..7-67 <br /> APPROVAL Address , <br /> CT-Y phone 8'R�,-� � parcel <br /> for City A <br /> Y�� <br /> SAM - Subd. <br /> CONSTRUCTION owner's Name — <br /> unit# <br /> in Address <br /> San Joaquin County Cit phone block It <br /> Y <br /> lot# t <br /> Precise location of property -r y Yes No <br /> sewers O <br /> water system <br /> Structure address S / drainage system—O <br /> Proposed use of structure(s) 4 �Rn, I � �Rn� I <br /> (e) Location of minimum sewage disposal area for septic tank and leach lines <br /> DRAW <br /> showing <br /> Irrigation drainagesPonding areas <br /> ( ) The lot ollishape <br /> {b) Abutting streets and other right-of-way easements {g) Location of ad p proposed driveways and <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 North <br /> W, <br /> w <br /> 1 € <br /> .r <br /> • <br /> F1 _ <br /> , <br /> t .....,.,... ��, ^— <br /> }= i <br /> rL.. <br /> - <br /> li <br /> v.-...... .. <br /> 1 <br /> 3 <br /> , <br /> 4 <br /> 7 E � <br /> , <br /> , <br /> .. - ` <br /> - <br /> + i € <br /> c <br /> , <br /> I <br /> Ik <br /> f € ( E <br /> I I <br /> } <br /> j <br /> 7 <br /> ki <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. f Y <br /> /O �I•�B Applicanfs_Signatwe <br /> Date - <br /> r - <br /> PLANNING DEPT. 1810 E. Hazelton Avenue • PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> 1. PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> 1: Property meets zoning requirements for both A. Encroachment Permit required 0 1601 E. Hazelton Avenue <br /> use and construction <br /> ' ,�No [] Zone B. Surface drainage established as shown 1. PROPOSAL APPROVED SUBJECT T <br /> 2. YesSPEL; CONDITIONS C. Fees A. Obtaining sanitation permit- <br /> 1 <br /> } a. Connection Fee 0 B. Obtain well/pump permit <br /> A. School district fee C� C. Change noted <br /> B. Floodway as shown b. Buy-in-fee 0 S <br /> C. Flood fringe 2. REMARKS 2. PROPOSAL DENIED D <br /> D. Noise impact 3. REMARKS <br /> 3. PARCEL MAP NO <br /> date by 6t� <br /> 4. REMARKS date Ih by ` 1 <br /> ✓ FLOOD CONTROL: date i ® St—DG. INSP. 14 53/79 <br /> by <br /> dated 3 bG - --- .. <br /> O �' <br />