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in Address __ 0__ <br /> _ ' — unite <br /> San Joaquin County City phone / block s - <br /> Precise location of property tot s Yes No <br /> sewers <br /> structure LJdressQ water system © El <br /> �, � drainage system—[—j L_, <br /> posed use of stfucture(s) s / Cr /-P- <br /> DRAW <br /> P' <br /> 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 IoCatior>x of.existing and proposed septic tanks and welts (1) WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> I I I I l6 or <br /> r i C _r-I F 1 <br /> i f 1 y , <br /> yk <br /> I <br /> E _ r r 1 <br /> 1 , <br /> - <br /> 1+*� <br /> 1 <br /> t. <br /> i- i <br /> �.... <br /> T.T11 _ <br /> _ y <br /> 17 <br /> s T <br /> �� <br /> ^ .tom i } 4-{ r { 1I ' <br /> -J1 <br /> F, <br /> T' <br /> J p <br /> -.r. <br /> S <br /> Imo' i � L,. <br /> �.- l I I <br /> _ >rw <br /> fikl <br /> `f <br /> _I. <br /> 44, <br /> i- I <br /> + j _ r _1 3- a <br /> ... <br /> I <br /> 1 <br /> I � <br /> 1 1 i I ! <br /> _ <br /> .,..,-I j :Appr'mr:Sc=3s 1. <br /> Applicant certifies that the property for which the APPROVAL is sought Is descrlt*d as above and that all existing structures on the property are <br /> shown on the abo plot pl n. # <br /> Date <br /> Applicant's Signature <br /> • PLANNING D 1810 E. Hazelton Avenue . PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. . LOCAL HEALTH DISTRICT <br /> operty is zoning requirements for both •PROPOSAL APPROVED SUBJECT T ENVIRONMENTAL HEALTH DIVISION <br /> use and struction / A. Encroachment Permit required ' 1601 E. Hazelton Avenue <br /> Yes No © Zone �L '� B. Surface drainage established as shown 0 1. PROPOSAL APPROVED SUBJECT T0: <br /> 2.SPECIAL CONDITIONS C. Fees A. Obtaining sanitation permit <br /> A.School district fee © a. Connection Fee Q B. Obtain well/pump permit <br /> — <br /> o c�� r.., .. �. ��„W, r-, b_ Buv-in4ee- © C.Change noted <br />