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APPLICA,.TION Applicant's Name ��� �' -� � st, -s*'iay Assess or'sParcel No. <br /> for E�] Contractor Authorized Agent ,_ book <br /> APPROVAL. Address , i <br /> page <br /> for City F phone parcel �l <br /> CONSTRUCTION Owner's Name-­o!� 7- ,.r<, _,1_3. f ,� 1 <br /> .�+ < Subd. <br /> ;�" c� .,r r:.rrnj.rlJ. <br /> San Joaquin County Address I1city, -�-- ---��?�— -..w.. ., /' � unit 4 <br /> phone T r�' - block rt <br /> Precise location of property a-0 1 l ,1�I <br /> 1_1176 r UA . _cl_ko��S� — lot n Yes No <br /> - f <br /> Structure address ^ I sewers 0 �� <br /> water system 0 <br /> Proposed use of structure(s) ^` 1 t.�';'Nj t � drainage system <br />' DRAW (e) Location of minimum sewage disposal area for septic tank and leach lines <br /> (a) The lot or parcel involved, showing shape 8r 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 and distances to lot lines (h) Levees, with the crown shown <br /> � � OPOSED STRUCTURE or ADDITION <br /> _ _ ' <br /> The locations of existing proposed septic tanks and wells (€) WITH DOTTED LINES, THE PR< �µ . . - _.. <br /> 7-1 <br /> /North\- <br /> -4- <br /> 7- <br /> 4 <br /> ... - <br /> _ i �_ _ <br /> L- <br /> - - <br /> , <br /> - <br /> .. .. <br /> ,- <br /> :_....vi--.t� _ 44 , <br /> _ <br /> : I <br /> �: Ate., . ,•L:� �------------ <br /> -7.r- :.. _ �_ <br /> >- <br /> ( . <br /> I <br /> r <br /> AL <br /> .. - ..,,... <br /> c <br /> m <br /> ten- <br /> . <br /> wlwsswwywnrc ' <br /> e <br /> w � <br /> Apprmrr Scali 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 <br /> �above plot plan. <br /> Date�A <br /> _ - Applicant's Signature <br /> • PLANNING-DEPT. 1810 E. Hazelton Avenue • PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> L Property meets zoning requirements for both 1. PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction . ? , A. Encroachment Permit required�'::.�e'~� 1601 E_ Hazelton Avenue <br /> Yes FV No = Zone [ B. Surface drainage established as shown 1. PROPOSAL APPROVED SUBJECT TO: <br /> 2. SPECIAL CONDITIONS C. Fees A. Obtaining sanitation permit <br /> ,A. School district fee 0 a. Connection Fee 0 B. Obtain well/pump permit ` <br /> B, Floodway as shown 0 b_ Buy-in-fee C. Change noted 0 <br /> C. Flood fringe 0 2, REMARKS �.f Ori / - �= 2. PROPOSAL DENIED 0 € <br /> 0. Noise impact [] / + R 3. REMARKS d1AZR1-1 �.�•.^ <br /> 3. PARCEL MAP N0. <br /> c date +✓ � - by rt� x .r �G3�! �. �k,M y4j, }Z r <br /> 4. REMARKS ifr � tf f Y) (,z rs ! - r � 1, .+.'X + <br /> -HAf I L V ►?k 1, , I -5 j,4 to . ' FLOOD CONTROL: date � date- t !0118 by <br /> date.f -f'1f3e1. by `ri by ® BLOG. INSP. 14 f3 7 <br />