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I - �� s Parcel No.. <br /> i APPLICATION Applicant's N a me JJn f� sL� I Assessor'A <br /> C n r for Authorized Agent Z .. <br /> o t ac <br /> g book <br /> f. r <br /> rte, � <br /> 0 <br /> APPROVAL Address lu A-� 4–,—A-tcxw G page 77 <br /> I for City - phone h ofc '_ parceE 7i <br /> CONSTRUCTION owner's Name <br /> - SLbd <br /> in Address�l� � --Tts <br /> unit 9 <br /> E Son Joaquin County CitylI phone (,`o X11 block r <br />! f Precise location of property.LsaT- - LLu fc, �- 1r7+�r J (-dart)y lots j-1 <br /> Yes <br /> I <br /> Yes No ' <br /> �l <br /> sewers <br /> Structure address water system_[] <br /> Proposed use of structure ts} ��/� I P S tl �. drainage system_[7] L�: 1, <br /> DRAW {e)Location of minimum sewage disposal area for septic tank and leach lines <br /> fat The lot or parcel involved,showing shape&dimensions Ifl Irrigation or drainages ditches,waterways and drainage pending areas <br /> {h) 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 fines Ih)Levees,with the crown shown <br /> Idl The locations of existing and proposed septic tanks and wells (i1 WITH DCTTED LINES,THE PROPOSED 57RUC7URE or ADDITION <br /> PM=PMi <br /> E <br /> �riNr 2- App— Sate l <br /> Applicant rtifies that the property For which the APPROVAL is sought is described as above and tat all existing structures on the property,are <br /> shown of the above plot plan. j�. <br /> t` \ <br /> oats l� T Applicant's Signature1 j <br /> .PLANNING DIV, 1810 E.Hazelton Avenue . PUBLIC WORKS DEPT. 1810 L.Hazelton ve. • LOCAL HEALTH DISTRICT ` - <br /> - 1.Property meets zoning requirements for both 1.PROPOSAL APPROVED SUBJECTT VIRONMENTAL HEALTH DIVISION <br /> useand con truction ff A. Encroachment Permit required -IG01 E.Hazelton Avenue _ <br /> Y. Yes � o Zone =✓ /� _�a B- Surface drainage established as shown 1.PROPOSAL APPROVED SUBJECT TO: - <br /> 2.SPECIAL CONDITIONS C. Fees A.Obtaining sanitation permit <br /> A,School district fee L.{' a. Connection Fee © 8,Obtain well/pump permit == r <br /> h H. FEoodway as shown CD It. Huy-in- e C.Change noted 0 ( x} l <br /> C.Flood fringe 2.REMAR 5 �� 2.PROPOSAL DENTED <br /> j, <br /> D.Noise impact �� 3.REMARKS °• !��*��^=t/' /` -- <br /> 3.PARCEL MAP NO > '�� -1 <br /> date- by <br /> 4-REMARKS y!.'-•.c-�_�lir l <br /> date -i(n by <br /> FLOOD CONTROL: date <br /> date . by,/�f,`.. v --�' by <br /> t � ; ' rS fir,- <br />