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APPLICATIONApplicant's Names l�= ��/''�!S0' �/n k}i ?✓• �'ci/.;a'_ Assessor's Parcel No. <br /> for ciiContractor Q Authorized Agent book <br /> APPROVAL Address %/�/� A%,, . / r! <br /> r paw - <br /> for City_ �J1A//{Pr.s h:l 4;"',2(aP parcel 5` <br /> CONSTRUCTION Owner's Name 4-V4, * Cn�k th N/-f _ Subd. <br /> in Address <br /> - unit a <br /> 11010 Son Joaquin County City phone <br /> block s <br /> Precise location of property /,j ? ��� .� �/� .' F lot n <br /> Ft 01,;-,, ! ;•;J 46 /20 i r'/ Yes No <br /> sewers Q i- ; <br /> Structure address water system_Q E, <br /> Proposed use of structures) /7J•,v fry, ,rte 9M drainage system—Q [ <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 locations of existing and proposed septic tanks and wells (i)WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> 47 FT <br /> j <br /> - ---- <br /> -- <br /> - - <br /> - <br /> I <br /> — <br /> --4 -- <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 /> T7P—rwertymeets zoning requirements for both 1.PROPOSAL APPROVED SUBJECTJq:P •ENVIRONMENTAL HEALTH DIVISION <br /> use and construction ( ` A. Encroachment Permitrequired�_ 1601 E.Hazelton Avenue <br /> Yes (j!2No Q Zone �f Y� B.Surface drainage established as shown Q 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SPEMAL CONDITIONS C. Fees A.Obtaining sanitation permit CZYN, <br /> A.School district fee 0 a.Connection Fee Q 8.Obtain well/pump permit tQ. <br /> on 8. Floodway as shown Q b. Bu <br /> y-in• C.Change noted Q <br /> C-Flood fringe Q 2.REMARI S -r 2.PROPOSAL DENT D Q <br /> D.Noise impact <br /> Q 3.REMARKS _ <br /> 3.PARCEL MAP N0 date f by Sf. <br /> 4.REMARKS dateelm - by ti• � •' <br /> '7`7` FLOOD CONTROL date / . <br /> data�-1+-�iL�by by I>!L,l �/ a WASP. <br /> 1 <br />