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APPLICATION Applicant's Name,_ ... Assessor's Parcel No-• .- -`� <br /> for (.,i onctar tt�or,xed A eru book <br /> APPROVAL Address _L_ .__.--- --- _ ._. _.,L%�'��,,� page --- <br /> for City _. __. .. ._. __._....__ _ __.phone___ 1 <br /> parcel <br /> CONSTRUCTION owner's Name. ----------- Subd.� <br /> in Address _ _ - unit n <br /> Son Joaquin County City phoneT <br /> block� <br /> Precise location of property lot <br /> oel __ Yes No <br /> sewers <br /> Structure address -- water system CD E.. <br /> Proposed use of structurets} . <br /> drainage system—E] i <br /> DRAW (e) Location of minimum sewage disposal area for septic tank and leach Fines <br /> (a) The lot or parcel involved, showing shape &dimensions (f) Irrigatiun 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 ADDiiTION <br /> 8a!! ft=pma,* <br /> K E <br /> �r <br /> pt , <br /> f ; '�4 ati+MY�+.i.�.�+.-..... i. rlh-�.�� ..., _, w,.•�Mw.-.,f..T r.:f . <br /> �. <br /> —6� ...r. w.®_I--,Y _,.wx..ocb�..�_�.,�-+..rr..W_'.. p•� l..f.,.w.,«r,.....—.�...-.•-�.w. — _ ._ _ •i .. � , �_ <br /> vApprair 5cnie I i <br /> Applicant certifies that the property for which the APPROVAL is sought is described as a ve apkd that ail existing structures on the property are <br /> shovrn on the above plot plan. e+ w <br /> Date �} ...__— �.. <br /> Appl:cant's Signature <br /> • PLANNING DEPT. 1810 E. Hazelton Avenue . PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> 1. Property meets zoning requirements for both 1. PROP05Ai_APPRQVE;D SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permit required--_ rr-] 1601 E. Hazetton Avenue <br /> Yes J-� No i--� Zane _--,-._— B. Surface drainage established as shown r_-� I. PROPOSAL APPROVED SUBJECT TO: <br /> 2. SPECIAL CONDITIONS C. Fees A. Obtaining sanitation permit_ C] <br /> A. School district fee i-) a. Connection Fee ______� _-� i=l B- Obtain wetl!pump permit U <br /> B. Floodway as shown _l b. Buy-in-fee.__—____,------___ i ) C_ Change noted L� <br /> C. Flood fringe_._ — ._ 1 2. RE MARKS _ 2. PROPOSAL DENIED <br /> D. Noise impact__ _-i �T—�-- <br /> 3. PARCEL MAP NO. _ --- - - — 3. REMARKS_ <br /> _ date----,-.by ..P 'r <br /> 4. REMARKS _ - <br /> - _ FLOOD CONTROL: date � _-- date _ _by <br /> date by_. ., -.__..� by by --- <br />