Laserfiche WebLink
APPLCATION Applicant's Name _ Assessor's Pmee*f'►e: <br /> .r� fir L) Contractor U Authorized Agent book,__r <br /> APPROVAL Address paha <br /> for City phone — parcel' <br /> gONSTRUCTION Owner's Name Subd <br /> In Address <br /> San Joaquin County — unit e <br /> City phone block <br /> Precise location of property _ — lot a <br /> Yes No <br /> WL sewers <br /> Structure address water system © Q <br /> Proposed use of structure(s) drainage system 0 <br /> DRAW (e) Locatic n of minimum sewage disposal area for septic tank and leach lines <br /> (a) The lot or parcel involved, showing shape 8 dimensions (f) Irrigati In or drainages ditches, waterways and drainage ponding areas <br /> (b) Abutting streets and other fight•of-way and/or easements t'g) Locatil n of existing and proposed driveways and encroachments <br /> (c) The locations of all existing building and distances to lot tines (h) Levees, with the crown shown <br /> (d) The locations of existing and proposed septic tanks and wells (i) WITH LOTTED LINES, THE PROPOSED STRUCTURE or ADDITION <br /> , <br /> t_ 1_ -1N4 ath <br /> > <br /> &a.�POW. <br /> •yT1 <br /> Age <br /> 01 <br /> 30 .4 <br /> -17 <br /> r„ <br /> r <br /> , <br /> ._ ]� <br /> la.3 <br /> A . S <br /> Applicant certifies that the property for which the APPROVAL is sought is descr,bed as above and that all existing structures on the property are <br /> shmm 9n the above plot Plan. <br /> Date A 1pIicant's Signature_ - - -------- =-- - <br /> • PLANNING.DEPT. 1810 E.Hazelton Avenue a PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> 1. o erty meats zoning requirements for both I. PROPOSAL APP 1--D SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Perr W required Q 1601.E. Hazetton Avenue <br /> Yes p' No 71 zones. B. Surface drainage e::tabfished as shown Q I. PROPOSAL APPROVED SUBJECT TO. <br /> 2.SPECIAL CONDITIONS C. Fees A. Obtaining sanitation permit— U <br /> A,School district fee Q a. Connection Fee Q B. Obtain well/pump permit . Cl. <br /> B. Floodway as shown © b. Buy-In-fee Q C. Change noted Q <br /> C. Flood fringe - - Cl 2. REMARKS 2. PROPO,;A�,DENIED <br /> 0.Noise impact Q 3. REfVWIiK <br /> 3,PARCEL MAP NO. <br /> d. REMARKS ' date =- >y <br /> date by <br /> FLOOD CONTROL: (ate <br /> date r by by <br /> ® BL r7 G. kN 3A. If 18/7Q <br /> , <br />