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Plot Plan Application <br /> SRN JUAQUIN COUNTY DEPART <br /> MENT OF PLANNING RND BUILDING,INSPECTIQN <br /> Uwner's me. ter' �. S i L! - A.P.N. <br /> Nap <br /> Address ,�1 IJ Subd_namme �.✓ �M, _ <br /> e..! <br /> City. r - map s <br /> Zip 15b phone►13k - 15 <br /> f bl/lots ' <br /> 4 Appl lcant's Name <br /> Census Tr. <br /> []Contratawner Setback: <br /> . . <br /> Address. <br /> - front <br /> City <br /> Zip phone - y�1 left <br /> Precise <br /> I <br /> 0ti0nror <br /> Property ty r ri <br /> ht <br /> -. <br /> L <br /> ti f l.�;II, <br /> 7 R rear <br /> Structure address !3 ( ' el,,,'pj, Yes_ No <br /> sewers <br /> Proposed use of atnrctwefsl • f i C water system <br /> --—.f`1 i• drainage system_d <br /> I <br /> c� fat The lot or parcel involved,showingKOW , <br /> dirtfelFsFpn let Location or minimum sewage disposal area for septic tank and leach lines <br /> Ibl Abutting streets and other right-of-way and/or easements ffi Irrigation or drainages ditches,waterways and drainage ponding areas <br /> fc1 The locations of all existing building and distances to tot lines (g)Location of existing and proposed driveways and encroachments - 1 <br /> tlo The rotations of existing and proposed septic tanks and wells (h1 Levees,with the crown shown , '•; <br /> Th_ (1)WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> _T " i .. <br /> North <br /> +. - -- - l-i "- --� <br /> 1I e-- <br /> ( - <br /> - _ <br /> i <br /> ? - _ - <br /> 1 Applicant certifies that the property for which the APPROVAL is sought is described as above and that all existing struct <br /> shown on the above plot plan. / es-en the property are <br /> i <br /> Date <br /> Applicant's SignaturY�, <br /> •PLANNING DIV. 1810 E.Hazelton Avenue ♦PUBLIC WORKS DEPT, 1910 E.Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> •Propel 'ty meets caning requirements for tgth .P.——L APPROVED SUBJECT T0: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permll required 1601 E.H <br /> •Yes F[�• No i� Zone�- •40 B. Surface drainage established as shown Hazelton Avenue <br /> Z. <br /> SPE CYAL CONDITIONS 1.PROPOSAL APPROVED SUBJECT TO: <br /> r�- � C. Fees A,Obtaining sanitation permit <br /> A.School tlistrict fee 11--it�LLc�� a.�Connection Fee <br /> 'B•Floodfri as shown CD b Buy-i.� B-Obtain well/pump permit � _ <br /> C.Flood fringe 2.REMAR <br /> C.Change noted <br /> D.Noise impact ! 2,PROPOSAL DENIED <br /> i 3.PARCEL MAP ND. -�O f 0-4-1 '' 3.REMARKS��(�•'rc.ut,ir- <br /> �.REMARKS Ai_-_ .. f-.:_ date .T by .. <br /> r FLOOD CONTROL:date_ date_lc_i •-?? R_ by,� - <br /> i dale; - by i 0-11" by <br /> P1Ot Plan Valid Until = • f�+ �' If.TI� �Prl b� { Lill <br /> 6uIL101 P9+00%r -: <br />