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APPLICATION Applicant's Name 0J041 cST� Assessor's Parcel No..� <br /> for (,Contractor Q Authorized Agent book Z l <br /> APPROVAL Address NLP W r 41114-e�An LUft ; G page ZQ <br /> for City r'� G. phone h,�9a� parcel 7i <br /> CONSTRUCTIONOwner's Name 1 / <br /> Subd. <br /> in Address <br /> unit x �U <br /> San Joaquin County Cityu A tG phone � block x - Ur <br /> Precise location of property �'�\ �f' �f"/� -� J �Q r'a 1L -7e1 �1�� 1 lot 0 /_S ' <br /> Yes No <br /> sewers <br /> Structure address water system <br /> SS��."n•�^�\. _ <br /> Proposed use of structure(s)-6," ''e h- , LI ++'L_ drainage system C] <br /> DRAW (e)Location of minimum sewage disposal area for septic tank and leach lines <br /> (a) The lot or parcel involved,showing shape 8 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 (1)WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> North- _ <br /> 1 t <br /> SnU Poiat Pma* �.j�? � <br /> _... _ 1 <br /> I <br /> IV <br /> _ _ l <br /> i <br /> I � i <br /> d <br /> Appt—Scale <br /> Applicant rtifies that the property for which the APPROVAL is sought is described as above and t at all existing structures on the property are <br /> shown of the above plot plan. <br /> Date Applicant's Signature i <br /> .PLANNING DIV. 1810 E.Hazelton Avenue •PUBLIC WORKS DEPT. 1810 E.Hazelton v . •LOCAL HEALTH DISTRICT <br /> 1.Property meets zoning requirements for both 1.PROPOSAL APPROVED SUBJECT T VIRONMENTAL HEALTH DIVISION <br /> use and con iruction A. Encroachment Permit required <br /> 1601 E.Hazelton Avenue I' <br /> Yes I No Li Zone %✓ - B. Surface drainage established as shown Q 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SPECIAL CONDITIONS — C. Fees A.Obtaining sanitation permit— <br /> A. <br /> ermit A.School district fee C3/ a. Connection Fee Q B.Obtain well/pump permit C:q V <br /> 8- Floodway as shown Q b. Buy-in- e O C.Change noted Q <br /> C.Flood fringe Q 2.RE R S 2.PROPOSAL DENIED 0 <br /> D.Noise impact Q <br /> 3.PARCEL MAP N67 �5'—/;� 3.REMARKS S <br /> 4.REMARKS <br /> date by <br /> date _j7. hve'l <br /> �y .,✓ FLOOD CONTROL:date �7 q, <br /> date <br /> 7 1G i� hy,// v Y by �/�f�( 7Lr i f6Lo Yr£Sv:la la/aa <br /> �TF -7i'S F ( Fp rZ S f�T <br />