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Y' i 1 %--of- 0 I UCKTON O) <br /> M <br /> at Utilities De artm m Q c 91W�"(Vdr'ater Service A <br /> .-�JJ pplication <br /> AssessJr Parcel Number: . l ! OUt51de Ci LIR11#S <br /> Applicant's Name: Address of parcel: <br /> Address: Phone: © i-�;L_ V <br /> Date. <br /> Present Use: <br /> X—Residential_,Number of Units Proposed Use: Np <br /> Commercial ,Residential 1 <br /> _Industrial _CommercialyNumber of Units <br /> _Undeveloped _industrial <br /> _Other: —Other: <br /> Status of County approval: <br /> ------------- <br /> �• Community Development Department <br /> _ I/ Complies with City General Plan General Plan Designation <br /> Does not comply with City General Plan - e>. <br /> Require annexation to the City of Stockton <br /> ZRequire applicant to enter into a Conditional Utility Service Agreement <br /> JAMES E. GLASER, DIRECTOR <br /> COM I EVELOPMENT DEPARTMENT <br /> BY; DA�7 , <br /> 2. Public W rks apartment <br /> A. Ar a oenefit/Other.Fees _ <br /> $ <br /> $ <br /> $ <br /> B. CFD�99-1/Fees <br /> N® iii G1� qo-/ $ENCROACHMENT PERMIT <br /> JAMES B0 NINI UBLIC WORKS DIRECTOR REQUIRE FOR SEWER <br /> LATE <br /> BY: 4 Date: <br /> 3. Mun ipal Utilities Department <br /> A. Connection Fee $ D <br /> B. Other Requirements 2 5 Rco' <br /> C. Sewer 8"ervice <br /> t Approved <br /> —Approved, subject to: <br /> Not Approved <br /> MARKJ. MADISON, UNICIPAz. UTILITIES DIRECTOR <br /> BY: Date:_ <br /> 4. To Permit Center for collection of fees and iss ante of Permit. <br /> Distribution: Original to applicant <br /> Copies to: Municipal Utilities, Public Works, Community Development,finance,County Building <br />