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SU0012938
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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12 (STATE ROUTE 12)
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21024
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2600 - Land Use Program
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SD-94-4
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SU0012938
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Entry Properties
Last modified
11/19/2024 3:48:18 PM
Creation date
2/3/2020 8:36:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012938
PE
2680
FACILITY_NAME
SD-94-4
STREET_NUMBER
21024
Direction
E
STREET_NAME
STATE ROUTE 12
City
CLEMENTS
Zip
95227-
APN
02310017
ENTERED_DATE
1/16/2020 12:00:00 AM
SITE_LOCATION
21024 E HWY 12
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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APPLICATION CONTROL SHEET <br /> ...:.G:.:Y.::{.:.:.. ....:..... . .... ......::..... > f. <br /> r ;•. <br /> .� :i:•...G..C.::.}:•}•.•................ <br /> e n r o n ce of ':>.> <br /> {:.;':.Y':. to eras : nv i r t nl s €v t f <br /> ProApp Only: ❑Yes ❑ No roo: nocoipt Number: Dale: <br /> rllo Number: 5-0-!3 4 A roo: ,cam nocoipt Number: i colo Dole:( ($ <br /> rllo Number: roo: nocolpl Number: Delo: <br /> rllo Number: roo: nocelpt Number: Dole: <br /> Doscrlptlon of Project �'j' ,+�{� U�J�-r P VVzt w(x- <br /> Project Locntlon: ni '� � S�-JjZ} 'S�17� (F 15T- A-TV, ✓�r1•�� \Z 33Ud� <br /> W ET Gt J�rtt iSG J tZ6AO � � L'�AA wt3 <br /> ) <br /> Addross: o7 Cv l: . 5T 12 r t'L <br /> eCzAt-:4,X3 APN(s): UZ-j- (00-(-7 <br /> General Plan Communlly: Gonomi plan Designation: N 1-c- <br /> zoning Map: Com. Property Zoning: ��j--`�c� FOverlay Zono(s): <br /> Adjacent Gcnorni Plan Zoning <br /> Norlli: (G <br /> South: A <br /> Ensl: A ICj- U^f O <br /> West: A, (s I AU �V <br /> 100-Your rlood ❑ Yes (-No Wllllnrnson Act ❑ Yes O-No Suporvisorlol District: <br /> Airport Aren: (-jLwe Specific Plon(s) ❑ Yes o: <br /> I listory: ')U L GC, , S D-�� (Lf <br /> ..::..::..:: L <br /> ..........................:...::•........ ............... ........ ................:.. .... .:moi:..:•::.:.•:... .v,.;�v..fr.4 <br /> All Appllcatlons <br /> Cprnplolod Appllc000n rorms Owners'Signature <br /> Copy of Deed or Prolhnlnnry Tlllo neport• Copies of Plan or Mnp ❑ <br /> 8'/w x 11' noducod Pin" or Mnp J- I lazardous Malorlals Disclosure Survey tl <br /> Development Impact Miligntlon rao rorrn ❑ Assessor and History Pages tl <br /> Nomas List • ❑ Sewer/Wator'Will Servo'Lollar• tl <br /> General Plan Mnp• ❑ Zoning Map•. ❑ <br /> Solis noporl• tl Soils Suitability Study• ❑ <br /> Subsidence Area ❑ Yes ❑ No Expansive Soil Area tl Yes tl No <br /> " 71reso materials may not be rocluired for cerinin applications. Chock Ilio application typo for dolnils. <br /> Tenlalivo Maps <br /> Mnp Signed by Owner ❑ Trod Number and Name (Mnjor Subs only) tl <br /> Adjoining Proporly Owners Nnrnes on Mnp ❑ All Lots Numbered tl <br /> Contour Lhros tl Locntlon of Wall and Septic System tl <br /> Excavations <br /> nocimmntlon Plnn and Schodulo ❑ rinnneinl Gummitoo ❑ <br /> Typical Cross-socllons ❑ Elevation Cnlculation Sclwdulo ❑ <br /> Engineer's Slnmp ❑ <br /> Completed By: �v`M L� �L'� — -- Dnlo: -- t <br /> nppcnlr . nn <br />
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