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78-146
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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78-146
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Last modified
6/6/2019 10:11:48 PM
Creation date
12/2/2017 6:59:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
78-146
PE
4211
STREET_NUMBER
1E003
STREET_NAME
KEYSTONE
City
TRACY
SITE_LOCATION
30000 KASSON RD - 1E003 KEYSTONE
RECEIVED_DATE
3/20/1978
P_LOCATION
AL PICARD
Supplemental fields
FilePath
\MIGRATIONS\K\KASSON\30000\KEYSTONE\1E003\78-146.PDF
QuestysFileName
78-146
QuestysRecordID
1803344
QuestysRecordType
12
Tags
EHD - Public
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ql <br /> APPLI,(fXTION Applicant's Name Assessor's Parcel No <br /> for Ej Contractor 0 Authorized Agent book <br /> APPROVAL Address <br /> page <br /> for City phone _ <br /> parcel <br /> CONSTRUCTION Owner's Name — Subd. <br /> in Address <br /> - unit# <br /> San Joaquin County 1 City phone block# <br /> Precise location of property lot# <br /> ,- <br /> f <br /> /. Yes No <br /> sewers 0 r[-, <br /> Structure address water system 0 C <br /> Proposed use of structure(s) <br /> drainage system— <br /> DRAW <br /> ystem—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 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 ADDITION <br /> /Nort\h- <br /> ..... <br /> - - 1 <br /> i r - - <br /> __� ; <br /> i 1 ` <br /> 1 i <br /> 1 ; <br /> 7 W <br /> S 3 S <br /> p <br /> gg <br /> E <br /> t x <br /> a - u '. <br /> r <br /> E <br /> rc <br /> ,�. <br /> F 3 <br /> — <br /> ( <br /> * +� <br /> q <br /> ., 4=_ .. _ W,« ..«........ <br /> .. <br /> . <br /> 33 <br /> 77. <br /> ti r <br /> r <br /> .. <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 Applicant's Signature € -: <br /> • PLANNING DIV. 1810 E. Hazelton Avenue • PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> I. Property meets zoning requirements for both 1.PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permit required'`=' " 1601 E. Hazelton Avenue <br /> Yes 0 No 0 Zone B. Surface drainage established as shown 1. PROPOSAL APPROVED SUBJECT TO: <br /> 2. SPECIAL CONDITIONS C. Fees A. Obtaining sanitation permit— <br /> A. <br /> ermit A, School district fee 0 a. Connection Fee 0 B. Obtain well/pump permit— <br /> B. <br /> ermit B. Floodway as shown b. Buy-in-fee 0 C. Change noted 0 <br /> C. Flood fringe 2. REMARKS 2. PROPOSAL DENIED 0 <br /> D. Noise impact O a 3 3. REMARKS <br /> 3. PARCEL MAP NO. date ' ' +� by <br /> 4. REMARKS date �" by <br /> FLOOD CONTROL: date �- <br /> date by by ® BLDG. INSP. 14 (8/83 <br /> i <br />
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