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COUNTY OF SAN JOAQUIN <br />PLOT PLAN FOR CONSTRUCTION <br />1. Name and Address of Applicant <br />2. Owner's Name and Address (if not applicant) <br />3. Legal <br />4. Address or Precise Location of Structure <br />6. Proposed Use of Structure <br />6. Draw: <br />(a) The Lot or parcel involved, showing shape and dimensions. <br />(b) Abutting streets and other rights of way. <br />(c) The locations of all existing buildings and distance to lot lines. <br />(d) The locations of existing and proposed septic tanks and wells. <br />Holl Polar Pan Ody <br />(e) Irrigation or drainage ditches. <br />(f) Location of existing and proposed driveways and en- <br />croachments. <br />(g) WITH DOTTED LINES THE PROPOSED <br />STRUCTURE OR ADDITION. <br />- <br />Appmx: Scale 1 <br />APPLICANT CERTIFIES THAT THE <br />PROPERTY FOR WHICH THIS PERMIT IS <br />SOUGHT IS AS DESCRIBED ABOVE, <br />AND THAT ALL EXISTING STRUCTURES <br />ON THE PROPERTY ARE SHOWN ON THE ABOVE PLOT PLAN. <br />Date <br />Applicant's Signature <br />PLANNING DEPARTMENT <br />PUBLIC WORKS DEPARTMENT <br />HEALTH DEPARTMENT <br />1810 E. Hazelton Ave. <br />1810 E. Hazelton Ave. <br />1601 E. Hazelton Ave. <br />1. Property meets zoning requirements for both use <br />1. Proposal approved subject to: <br />1. Proposal approved subject to: <br />and construction. <br />A. Encroachment Permit <br />g sanitation permit <br />A. Obtaining <br />❑ <br />Yes-- No— Zone <br />Applicatic ❑ <br />B. Changes Noted <br />❑ <br />2. Remarks <br />B. Property line barrier established as shown ❑ <br />2. Proposal Denied <br />❑ <br />C. Surface drainage established as shown ❑ <br />3. Remarks <br />2. Remarks <br />Date By Date By�. <br />FLOOD CONTROL Date <br />By <br />Date <br />e BLDG. INSP. 14 <br />