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3 <br /> E <br /> I � f �.�.�.-»•--•.gym .�,.4,;�. ., , <br /> i ... � <br /> -; -- <br /> J7-i.. <br /> i <br /> ] - <br /> ;_ <br /> I - <br /> { <br /> i- <br /> —_ T. <br /> ( ( _ <br /> s <br /> T. <br /> } <br /> S' ...1 <br /> ,_. <br /> 4-4- <br /> ___ __. <br /> 1 <br /> 1 - <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 Applicant's Signature <br /> • PLANNING DIV. 1810 E. Hazelton Avenue • PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> 1: Property meets zoning requirements for both 1.PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permit required IWI E. Hazelton Avenue <br /> Yes � No �] Zone B. Surface drainage established as.shown (� 1. PROPOSAL APPROVED SUBJECT TO: <br /> 2_ SPECIAL CONDITIONS C. Fees A. Obtaining sanitation permit Q <br /> A. School district fee Q a. Connection Fee C S. Obtain well/pump permit 0 <br /> B. Fioodway as shown b- Buy-in-fee 0 C. Change noted C3 <br /> C. Flood fringe 2. REMARKS 2• PROPOSAL DENIED 0 <br /> D.Noise impact Q 3. REMARKS <br /> 3. PARCEL MAP NO. date by <br /> C REMARKS date by <br /> FLCOD CONTROL: date <br /> date by by (D BLDG, WSJ'. 14 (B/ <br /> Plot Plan Valid Until <br />