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APPLICATION <br />for <br />APPROVAL <br />for <br />CONSTRUCTION <br />in <br />San Joaquin County <br />Precise location of property <br />Applicant's Name <br />Address <br />city _ <br />Owner's Name <br />Address <br />city <br />[] Contractor [] Authorized Agent <br />Structure address <br />Proposed use of structure(s) <br />DRAW <br />(a) The lot or parcel involved, showing shape & dimensions <br />(b) Abutting streets and other right-of-way and/or easements <br />(c) The locations of all existing building and distances to lot lines <br />(d) The locations of existing and proposed septic tanks and wells <br />phone <br />phone <br />Assessor's Parcel No. <br />page _ <br />parcel <br />Subd. — <br />unit u <br />Hazelton Avenue <br />1. Property meets zoning requirements <br />for both <br />use and construction <br />block n <br />Yes F-1 No 0 Zone <br />lot a <br />A. School district fee <br />Yes <br />No <br />sewers <br />Q <br />0 <br />water system <br />Q <br />0 <br />drainage system <br />(e) Location of minimum sewage disposal area for septic tank and leach lines <br />(f) Irrigation or drainages ditches, waterways and drainage ponding areas <br />(g) Location of existing and proposed driveways and encroachments <br />(h) Levees, with the crown shown <br />(H WITH DOTTED LINES, THE PROPOSED STRUCTURE or ADDITION <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 />a PLANNING DEPT. 1810 E. <br />Hazelton Avenue <br />1. Property meets zoning requirements <br />for both <br />use and construction <br />Yes F-1 No 0 Zone <br />2. SPECIAL CONDITIONS <br />A. School district fee <br />B. Floodway as shown <br />E-] <br />C. Flood fringe <br />Q <br />D. Noise Impact- <br />mpact <br />3. <br />3. PARCEL MAP NO. <br />4. REMARKS <br />by <br />Applicant's Signature <br />. PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. <br />1. PROPOSAL APPROVED SUBJECT TO: <br />A. Encroachment Permit required <br />B. Surface drainage established as shown <br />C. Fees <br />a. Connection Fee <br />b. Buyin-fee E--] <br />2.REMARKS <br />date by <br />FLOOD CONTROL: date <br />by <br />1 LOCAL HEALTH DISTRICT <br />ENVIRONMENTAL HEALTH DIVISION <br />1601 E. Hazelton Avenue <br />1. PROPOSAL APPROVED SUBJECT TO: <br />A. Obtaining sanitation permit <br />B. Obtain well/pump permit <br />C. Change notetl <br />E-] <br />2. PROPOSAL DENIED <br />E-] <br />3. REMARKS <br />date by <br />G) BLDG. INSP. 1413/]81 <br />