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APPLICATION Applicant's Name i Assessor- No <br /> for L C actor _ Auth e - -_-- -- <br /> book <br /> i APPROVAL AddressC I^ /- _ --i- b P� <br /> . y ! page <br /> i for Cily .�, / �- / phone <br /> CONSTRUCTION Owner-,Name �7 —� parcel �? <br /> in /i ; �.. Subd. - <br /> Address / <br /> San Joaquin County <br /> City ./ n _ „. <br /> J r J phone block< <br /> —Precise location of property ()j - {^v r lot a <br /> T_r;-,_ •i-:{--�{` .ice i ll l r 1 .y�� Yes No <br /> Structure address r ' rte, �� ) f Jr sewers 1 1?G <br /> Jr / - --- water system_CI <br /> Proposed use of structures) - /��/lam'_ =�/�.��% / �--• -</l'/-Yc'��.� drainage system_;'_1 M, <br /> DRAW (el Location of minimum sewage disposal area for septic tank and leach lines <br /> (al The lot or parcel involved,showing shape&dimensions (f) Irrigation or drainages ditches,waterways and drainage ponding areas <br /> (b) Abu tl ing streets and other right-of-way and/or easements (g)Location or existing and proposed driveways and encroachments <br /> I 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 /> Ball F'ww Pm Qc ly <br /> if <br /> � l <br /> 1 _ 'x'`j ? Z t�� i �Q► <br /> i e v <br /> I <br /> r <br /> I <br /> • i <br /> Appros.Salle I— <br /> �pplicanl certifies that the of <br /> for which the APPROVAL is sought is described as above and that all existing structures on the property are <br /> .hown on the above plot plan. r <br /> Dale 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 required'- -eI- 1601 E.Hazelton Avenue <br /> Yes 1--jNoQ Zone (�.� B- Surface drainage established asshovin Q 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SPECIAL CONDITIONS C. Fees A.Obtaining sanitation permit <br /> A.School district fee Q a. Connection Fee O B.Obtain well/pump permit <br /> B. Floodway as shown Q b. Buy-in-tee Q C.Change noted Q <br /> C.Flood fringe Q 2.REMARK S('•"� - 2.PROPOSAL DENIED [-] <br /> D.Noise impact Q <br /> 3.REMARKS- _ <br /> 3.PARCEL MAP N0. dale ll. :,(�]j—by` <br /> 4.REMARKS•Ji t ren i !U t.l l Y,I-r-, Z I datf 7� by •• <br /> `-i•I':1�4 j''S'Ql'r r�/-� .�. L�� ) FL000 CONTROL: date - <br /> datej-i-'.�•.ai%�_by1 Fil-1 zyFlIPr by ® e c`ei i+sv. ri rir,u <br />