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APPLICATION Applicant's Name — � U/ - -.(>`. IV4��_ _ Assessor's Parcel No _ <br /> r • <br /> for ( _7 Contractor I 1 Authorized Agent book_ <br /> / <br /> APPROVAL Address F.2 15�4 J ---� _ page_/_r22_ <br /> phone_3d �! parcel <br /> for City `� <br /> ( CONSTRUCTION Owner's Name — — Subd. <br /> in Address — unit# <br /> San Joaquin County City— ` f�1 ph ne block <br /> Precise location of property _ Gfc� lot — <br /> Yes No <br /> sewers L_1 <br /> Structure address water system n Ir <br /> drainage system <br /> Proposed use of structure(s) ' <br /> DRAW (e) Location of minimum sewage dj4posal 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 /> North <br /> Bau p0im PIM out, <br /> . <br /> a <br /> ATrtrtr^i-RRRK fT <br /> - X11 , <br /> }. APP yT ►n . <br /> . . <br /> t <br /> r , <br /> 6 f d[ <br /> s <br /> Y <br /> P 1 1 <br /> w <br /> 41 <br /> � 4 <br /> Approx. Scale -- <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 /> '�shnwiron tfie above ploE plan - - — - —� �► <br /> Date Applicant's Signature `' <br /> f <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. PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permit required 0 1601 E. Hazelton Avenue <br /> YesNo 0 Zone ` B. Surface drainage established as shown 0 1. PROPOSAL APPROVED SUBJECT TO: <br /> 2. SPE IAL CONDITIONS C. Fees A. Obtaining sanitation permit 0 <br /> A. School district fee 0 a. Connection Fee B. Obtain well/pump permit 0 <br /> B. Floodway as shown [] b. Buy-in-fee C. Change noted 0 <br /> C. Flood fringe CJ 2. REMARKS 2. PROPOSAL DENIED <br /> D. Noise impact 3. REMARKS <br /> 3. PARCEL MAP N0,4 <br /> date by <br /> 4- REMARKSdate�a by N <br /> FLOOD CONTROL: date <br /> e BLDG. IN SP. 1413;791 <br /> date by <br />