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APPLICATION Applicant's Name t /// D(y u� /-J�,.�,lp��,l.i � �%i S:> Ass.!;or's Parcel No.-_ <br /> for 5irContractor C::]Authorized Agent book / <br /> APPROVAL Address <br /> for City /zw", PrP phone:lj`/ :7f�1 parcel S� <br /> CONSTRUCTION owners Nan. vim, w <br /> 7 subd. <br /> In Address - unit x <br /> San Joaquin County city phone block x - <br /> Precise location of propertyL(!s�J lot x <br /> Fr I i rJ 2r2 it 0/ C../ Yes No <br /> sewers E:j <br /> Structure address water system_(� <br /> Proposed use M structure(s) �J 9 drainage system --! - <br /> p` 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 locations of existing and proposed septic tanks and wells (i)WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> Wtpmii <br /> i <br /> 4:1- <br /> 071 4QI <br /> I _ <br /> G <br /> -- - - - <br /> S <br /> --- .— <br /> ,_� <br /> gpos.Sok 1 , <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 /> Date Applicant's Signature <br /> .PLANNING DIV, 1810 E.Hazelton Avenue •PUBLIC WORKS DEPT. 1810 E.Hazelton Ave. •LOCAL HEALTH DISTRICT <br /> -'--1.Property meets zoning requirements for both I.PROPOSAL APPROVED SUBJECT_TQ:P •-ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Perm it required- 1601 E.Hazelton Avenue <br /> Yes ff�� No O Zone �f T" B. Surface drainage established as shown 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SPEAA41-CONDITIONS C. Fees A.Obtaining sanitation permit <br /> - <br /> A.School district fee F--j a. Connection Fee B.Obtain well/pump permit [2�1 <br /> B. Fioodway as shown b. Buy-in- C.Change noted <br /> C,Flood fringe Q 2.REMtARI S -r- 2.PROPOSAL DENT D <br /> D.Noise impact .,^ <br /> PARCEL MAP N0� f 3.REMARKS ` <br /> date try -rf-- <br /> 4.REMARKS date by <br /> FLOOD CONTROL:date <br /> date —tly by �� _ Jy.os.n4» 14 IV <br />