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APPLICATION Applicant's Name v VE '4e E'eLjE Assessor's Parcel No. <br /> ` for Q Contractor IM Authorized'Agent 111 book �13 <br /> APPROVAL Address 197S LDWE,2 SAGR4lyrE.vJp Rd page �gp <br /> for City Ak Ampo Gr.44/,c., phone 3680183 parcel 2 T <br /> CONSTRUCTION owners Name SAME Subd. <br /> in Address <br /> unit b <br /> San Joaquin County City phone block n <br /> Precise location of property 7S M' �. GAF a Gw ire 34c, �A lot x <br /> /4M0 7$S– r N; d 4/00,0 94106E '420. Yes No <br /> sewers [] Q <br /> Structure:Jdress water system_p O <br /> G. L�V��I� gook" ADO 7rJaA/ drainage system_Q Q <br /> dosed use of structure(,) <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 aro 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 /> ,_� �6D7•G I p I Nartn <br /> I I <br /> r 4 Oar <br /> TR- <br /> :_ of . ~ _=� ._.. ._.__�►_ �-.. _ ='-- - '-- _:_ ��,+ <br /> 14 <br /> _._..�. - s-- y�•�� <br /> _�-_... _..-.�; _.... I'--__...__. =�._ — __ •.�.__ } �— __—_.. .._ter <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_.1:nt��Z Z an <br /> — 6 Z_ Applicant's Signature — <br /> .PLANNING DEPT. 1810 E-Hazelton Avenue .PUBLIC WORKS DEPT. 1810E.Hazelton Ave. •L L HEALTH DISTRICT <br /> .Property meets zoning requirements for both 1.PROPOSAL APPROVED SUBJE T TO• ENVIRONhIENTAL HEALTH DIVISION <br /> use and nstructlon �y A. Encroachment Permit requi 1601 E.Haxitm Avenue <br /> Yes No p Z me�(J B. Surface drainage established as sh p 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SP�itL CONDITIONS C. Fees A.Obtaining sanitation permit— <br /> L <br /> A.School district fee —Q a. Connection Fee Q B.Obtain well/pump permit <br /> B- Flucdway as shown _._Q b. Buy-in-(ee C.Change noted O <br /> C.Flood fringe Q 2.REMARK .Q 2.PROPOSAL DENIED <br /> D.Noise Impact—_ —_ t (A i,,,^^ 3.REMA <br /> 3.PARCEL MAP N _ – dater by al�.J <br /> 4.REMAR S date by <br /> LOOD CONTROL: date ---_- Y?- <br /> 14<9/]91 <br /> date – by_!C!J by <br /> I <br />