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t r / pSSC55or s rarcoi� ,— - <br /> 1 APPLICATION Applicant's'Name��- a — __ <br /> Contractor j" J Authorized Agent book <br /> for page <br /> "APPROVAL Address� �•Y 3ZG' 11 QQ <br /> i KAC'Y --Phone -J47 7� parcel <br /> I <br /> city, - <br /> 'r"tTRUCTION owners dame - sObd.�c���n,he2� <br /> in Address - unit r <br /> Son Joaquin Counir I city phone— blocky <br /> Precise location d property Q�`-1 `f'kAK __f'OV T7.••1 �I DC C"1P -��AtC-. lour��— <br /> Yes No <br /> / <br /> L4501�(�S5T�1=C 2AN'T t_1_i4A lit— — sewers O U� <br /> water system <br /> Structure LJdress drainage system__FJ Q� <br /> P• dosed use of structure(s) <br /> DRAW (a)Laatlon of minimum sewage disposal area for septic tank and leach Imes <br /> (a)The lot or parcel involved,showing shape 8 dimensions (f) irrigation or drainages ditches,waterways and drainage posting areas <br /> i (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 lh)Levees,with the crown shown <br /> (d)The locations ef existing and proposed septic tanks ane wSE <br /> ells (1)WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> , •, <br /> At <br /> y.'- fi-t , T+-1T_Ti <br /> �i7T i I LL <br /> : <br /> IT <br /> i <br /> 1 <br /> 1 i - r Y ,- <br /> ' I .•-: '-s •'T -a•~t�-+-•�.1,- :� r rte, r i I ' (--�- <br /> tt <br /> 4A 777 <br /> 1 --.-r- l , + -* __--�_ 1 i , ^3--------rte{' <br /> - <br /> 4. <br /> : t t : <br /> -j <br /> _ <br /> •}�-1 '- -j-'._�_ "ice ' ri I 1 • , ' <br /> tit <br /> ' ` --�• �-- -,- .T__a. ' Lam_. I r t 1 1 i <br /> _.•,`r .Y, j—r «J r I I 'ill. i- +- <br /> r -I <br /> r <br /> ' !_ �_,_-ice_ ' _ _•r. ( � ,-fit-'• �1i1`1Z� <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 Ile above plot plan. <br /> L»---«;--�=-`Appl+cantraSignature_'��--� <br /> . PLANNING DEPT. 1810 E,Hazelton Avenue U13 LIC WORKS DEPT- 1810 E.Hazelton Ave. .LOCAL HEALTH DISTRICT <br /> 1.Property meets zoning requirements far both PROPOSAL APPROVED SUBJECT T0: --ENVIRONMENTAL HEALTH DIVISION <br /> use and nsduclion A, Encraachmenl Permit required. 1601 E. Hazelton Avenue <br /> �- <br /> Yes 7No [-j Zone -1� _ B. Surface drainage established as shown Q 1.PROPOSAL APPROVED SUBJECT T0: / <br /> 2.SPECIAL CONDITIONS C. Fees A-Obtaining sanitation permit ) <br /> A,School district fee— _Imo_. a. Connection Fee CJ B.Obtain well/pump permit_ <br /> i B. Floodway as shown. _ _ = b. Buy.in-fee r Q C_Change noted - <br /> i <br /> C. Flood fringe__— 0 2.REMARKS 1 ~� 2.PROPOSAL DENIED -C� <br /> f D.Norse impact _ [I _ •-P 3.REMARKS_ - - <br /> } 3.PARCEL date-N0.MAP _ <br /> ,I � —I'S^ by <br /> 4.RE MARKSrSQVr?S7J� �SI p _E date 112 <br /> S S�v�M�t FLOOD CONTROL: date—, &I BLDG. IN SP <br /> Q by- <br /> . <br /> date..( by <br /> i <br /> l <br />