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.APPLICATION Applicant's Name 0-/, V <br /> A�'s Parcel No <br /> for :1 rector (_)Aulhorize�Ant _- <br /> APPROVAL Addressj book 2y.� <br /> For city :5 ,i�� . ! j . page <br /> per <br /> CONSTRUCTION owner's hwme a parcel �— <br /> r in soba. _ <br /> Address / . <br /> San Joaquin County / - unita <br /> City ��! � � <br /> ♦r / phone -f?• block« _ <br /> Precise location of properlty1-c �('-T'�... pp .�1 ��.. �� lot a <br /> �11 `i---L�•i1Ct r Yes No <br /> Structure address sewers CI Jam' <br /> ! water system_C-1 <br /> Proposed use of structures) S/,i_X//�". F-�h.I,/c� r'F�S1 JfkX`y drainage system_;__-( M•, <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 richt-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 /> BLU PD=Pm Only N <br /> -7Vic`r`S <br /> r <br /> 1 J V <br /> r <br /> r <br /> i <br /> r <br /> 1 J <br /> ' Y1 <br /> Appto=.Scale i— <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. r <br /> Date Applicant's Signature <br /> •PLANNING DEPT. 1810 E.Hazelton Avenue •PUBLIC WORKS DEPT. 1810 E.Hazelton Ave. •LOCAL HEALTH DISTRICT <br /> 1.Property meets zoning requirements for both 1.PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permit requir ',)[] 1601 E.Hazelton Avenue <br /> Yes i� No O Zone� -L40 B. Surface drainage established aO 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SPECIAL CONDITIONS C. Fees A.Obtaining sanitation permit CsL <br /> A.School district lee Q a. Connection Fee B.Obtain well/pump permit <br /> B.Floodway as shown O b. Buy-in-fee CD C.Change noted C3 <br /> C.Flood fringe a 2.REMARKSrt,) — 2.PROPOSAL DENIED <br /> D.Noise impact Cl Y I 3.REMARKS-T)� <br /> 3.PARCEL MASP1 NCO.- date <br /> 4.REMARKS• tY'r1 �� ter.)l Yr _ / , - `dalf Vim. Y. - ... . <br /> ��Ylld) FLOOD CONTROL:data i)-1 -7d b it <br /> dat>'�-'''•'��^-byI Ei,tz 1ZImer by 1•Ia�)9 <br /> l e <br />