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Assessor's Parcel No. <br /> APPLICATION N Applicant's Name 13 + <br /> Cant actor F--i Authorized Agent it book s� <br /> forII pagey <br /> APPROVAL Address I + <br /> forp <br /> City R eI-le r phone --4t&- '7__7- parcel t <br /> CONSTRUCTION owner's Name + <br /> 4114 MC' !.%� ii Subd. Taduc�lc'rZr <br /> in Address I� unit# <br /> San Joaquin County City phone �x' block - a <br /> Precise location of property 'C -)'T� �� � lot# M <br /> :k�d �r 0 I G �. 1�fJE P _ ,res No <br /> �I sewers � 0� <br /> Structure:.Jdress water system C:1 0� <br /> �l drainage system—E-1 CRI, <br /> P�-.posed use of structure(s) 3'�RM -N r C/�..- i�AM 11.5 iP � /nI !��' 0 1 � ' <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 /> NBrth <br /> .it <br /> LI <br /> ttl <br /> -�.. -t----'--^ <br /> -"r <br /> r <br /> E ! <br /> + a <br /> i <br /> Y <br /> r 7 "-� <br /> 3 , <br /> 1 ! i <br /> _ ...._ � <br /> n i k <br /> ..,. _ � -�--,j-�-- � -1--.` t_� �� f08x ���f_--..-.�.. •!�3 !„„„-W 4__i_.k �_ <br /> , <br /> - k r <br /> ._L.., ..��. "k fes,. q 1 <br /> , 5 <br /> [- �rt <br /> � E � l e <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 th above plot plan. <br /> i <br /> Applicant-saSignature <br /> CAL HEALTH <br /> . <br /> PLANNING DEPT. 1810 E. Hazelton Avenue • <br /> PUBLIC ROPO AL APPROVED SUBJECT TO Ave- ENVIRONMENTALDHEALTH DIVISION ++ <br /> 1. 1: Property meats zoning requirements for bath s 1601 E. Hazelton Avenue 6 <br /> 0 <br /> use and�nstruction .T] r� A. Encroachment Permit required ® n <br /> Yes ® No Q zone '�-�- B. Surface drainage established as shown 0 1. PROPOSAL+APPROVED SUBJECT T0: <br /> A. Obtaining sanitation permit <br /> 2. SPECIAL CONDITIONS C. Fees t <br /> A. School district fee 0 a. Connection Fee Q B. Obtain well/pump permit r <br /> b. Buy-in- 1:2C. Change noted D ' <br /> B. Floodway as shown 0 2. PROPOSAL' DENIED D <br /> C. Flood fringe Cl 2. REMAR, S <br /> D. Noise impact + 3. REMARKS �I <br /> 3. PARCEL MAP NO. r •� <br /> 4. REMARKS- PPS �y Ir Xst - date f by date # r y �+ . <br /> FLOOD CONTROL: date f II <br /> il) BLDG. INSP. 14 (9/79) <br /> by <br /> date ��- <br /> by <br />