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Plot Plan Application �-- -° <br /> SAN_JOAQUIN COUNTY DEPARTMENT OF PLANNING AND BUILDING INSPECTION <br /> - - A.P.N. / 3 lL <br /> Owner's Name Mx. G i <br /> Subd.name <br /> Address 4�!a 41- 910W FnQ1 <br /> / p 22' map u <br /> &i <br /> City D j Zip G>4, ISZ4Z. phone J-"����1g bl/lot# <br /> Census Tr. <br /> Applicant's Name G y V Setback: <br /> Contractor Owner �0 <br /> Address <br /> 1� l �b 41• l `7 - -1 • front <br /> City &W/ q�� M phones 3-5.-T 1 g left /� <br /> Zip ( —'7 �' y <br /> --- - - right ! <br /> Precise location off property i" Q17Nom45 OF NUR*11 —14m�- a&,-,r- rear 5,6 <br /> {_�oFm F-40171a� l e►J Yes No <br /> Structure address N� TV l �13n ��/ R-0 . sewers 0 <br /> = water system � 0 <br /> Proposed use of structure(s) NEli✓ rZ45S I hiE .P,- drainage system_[� <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 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 (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 /> _ <br /> - j • , Orth <br /> T - 10 <br /> r_. <br /> T� <br /> J <br /> li <br /> C� + <br /> j <br /> I <br /> - I <br /> 4 . <br /> l <br /> _ - <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.p� _ <br /> Date 3 3rd Applicant's Signature <br /> • PLANNING DIV. 1810 E. Hazelton Avenue • PUBLIC WORKS DEPT. 1810 E. Hazel Ave. • LOCAL HEALTH DISTRICT <br /> I. Property meets zoning requirements for both 1. PROPOSAL APPROVED SUBJECZ,V ENVIRONMENTAL HEALTH DIVISION <br /> use and conAuuction A. Encroachment Permit required �i-a ,` = 1601 E. Hazelton Avenue <br /> Yes No Q Zone --�ld B. Surface drainage established as shown = 1. PROPOSAL APPROVED SUBJECT TO: <br /> 2. SPECIAL CONDITIONSC. Fees A. Obtaining sanitation permit <br /> A. School district fee a. Connection Fee = B. Obtain well/pump permit <br /> B. Floodway as shown Q b. Buy-in-fee L C. Change noted 0 <br /> C. Flood fringe 2. REMARKS I IB C Sh o w 2. PROPOSAL DEN ED 0 <br /> D. Noise impact , 3. REMARKS j- <br /> 3. PARCEL MAP N0. <br /> date by <br /> 4. R R ate 53 by <br /> FLCOu CONTROL: date <br /> J. <br /> date 23,43 A�Vby by ® BLDG. IN G ceie3 <br /> Plot lan Valid Until <br />