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SAM-41JAQUIN COUNTY DEPARTMENT OF PLANNING AND BUILDING INSPECTION <br /> a I <br /> owner's NaPh O -77,)_�q(� A.P.N- <br /> me C� /o .'�-- <br /> �� t-Vic sem- '—��� w Subd.name <br /> Address - -- <br /> City A r map a <br /> _ y ' ZiP phot�r bl/!ot+r <br /> 1 JU/7 n 673 <br /> Applicant's Name Cei.sus Tf. <br /> CD Contractor C] Owner Setback: <br /> Address front <br /> CityZip p tett <br /> right <br /> Preyjse location of property. /0 ',�„•,,,•_ <br /> SIDE of A4Die,�- ,en�Drear J O �GtE• es No <br /> Structure addreZs��?c 4 SUS sewers 0 ED <br /> water system 0 Cj <br /> Proposed use of structures ' / drainage system—0 <br /> DRAW (e) Location of minimum sew912e disposal area for septic tank and leach lines <br /> (a) The tar par I vgiyed,showing shape rmen Irrigation or drainages ditches,waterways and drainage ponding areas <br /> (b) Abut Irl scree U1, <br /> other right-of y and (Q Location of existing and proposed driveways and encroachments <br /> (c) The ations gqc1c�ting 4uipidrard ist t lines (h Levees, with the crown shown <br /> (d) The ocation sbYnk acrd se and IIs (I WITH DOTTED LINES, THE PROPOSED STRUCTURE or ADDITION <br /> ...T. ..' <br /> 1— * Tf' <br /> a-t North 1 <br /> a _ <br /> . J ! cls <br /> VK� <br /> + ,4 <br /> r <br /> } <br /> ZL <br /> 1-j 04 <br /> Lj <br /> ---�=- <br /> ^t`? , <br /> 1 <br /> 17 <br /> r_ --------, + , <br /> .i _. .. . <br /> 1Y <br /> Applicant certifs <br /> shown on the above plot plant.that the property for which the APPROVAL Is sought is described as above and that all existing struct�el <br /> the property are <br /> Date / <br /> 9`--- ` Applicant's Signature <br /> • <br /> PLANNING DIV, 1810 E.Hazelton Avenue • PUBLIC WORKS DEPT. 1810 E- Hazelton Ave• LOCAL HEAL H DISTRICT <br /> Property meets Zonin <br />