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- bt Plan Application <br /> SAN JO.AQUIN COUNTY r_PARTMENT OF PLANNING AND BUILDING INSPECTION <br /> , w� — A.P.N. _ IO', <br /> jV <br /> Owner's Name L .n r, f ' t fa y ' 'J Subd:name J <br /> Address , ''i { � • {' ? 1 L^ t t �i map r? -- <br /> City C.ts rM- t3 Zip 1t.• phone :>J -Z bl/lotto <br /> G-4, <br /> Census Tr. v <br /> Appl icant's Name G �`f.r' t �A n 4 N <br /> �— -- - - Setback: <br /> Ej Contractor t� Owner <br /> ` Address .✓/'7 nn C;5 A jwt/e - _ front , +` <br /> ` left L') I <br /> City Zip phone i <br /> right :;/�rf=— <br /> I T Precise location of property���)k► 1' i 0�4'�,T f K r: K [�� 'Tlrl/ �C�` . .hf'ar rear (( ' <br /> rti if'i 'i ' Yes No <br /> "qtr' I -� , /� Cy sewers-- � � <br /> Structure address t t �~ r + water system <br /> Proposed use of structure(s) 1 a+ N [ i•._f c ; _ drainage system <br /> DRAK _^ (e) Location of minimum sewage disposal area for septic tank and leach lines <br /> (a) The lot or parcel involved, showing shape &dimensions (f) hrigation or drainages ditches, waterways and drainage ponding areas <br /> (b) .,outtinR 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 /> l r04 04 <br /> } <br /> 717 -� <br /> _ <br /> _I <br /> t + <br /> 01L <br /> 41 <br /> -- <br /> � L <br /> _ —"- <br /> } <br /> .21j <br /> _ <br /> 1 l <br /> ,_ <br /> it 'u74CY.." <br /> r- <br /> 1 <br /> _ <br /> r- <br /> i <br /> policant 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. 7. <br /> 4 <br /> ate -. _' "_�.._ __ — Applicant's Signature <br /> F'I_ANNING DIV, 1810 E. Hazelton Aveftae s PUBLIC WORKS DEPT, 1810 E. Hazelton Ave. « t,.F1Ei411H. DI RICT <br /> I. Property meets zonirig requirements for both T Pf20POSAL A4PPOVED.SUBJECT TO ENVIF'ONWNTAI HivAt,TH DIVISION <br /> a. 180 Haltoft Avrittrt3 • . <br /> :Ise aqd onstr rC trbn. A. Lnc;roachment Permit r2qusred,; ii -4 [ ] <br /> Yes (,`�•�] B. Surface drainage established as shoWfl � Al Af�1 thV 'SUHJE`CT Tb: <br /> 2 Sf'ECIA�CQNDIT`II�tVS j C. Fees t A' t� lnittq ti�ih(tbtlbn phrrlTlt R <br /> A. SC'hool.drStrlet,fee a. Connection Fee t 3 4 , t'Tbtr�ttlVditllr'pt5ht j tftstX <br /> b. Buy in�e& <br /> i:, {oox(ffrng8 a�a a s �.., i_1 a. R�.NrA, a;�. <br /> D. Noi%e It <br /> 3. PARCEL <br /> a.- <br /> J x t date f [ .� r #d- I)y <br /> 4 REMARKS <br /> FLOOD CONTROL: <br /> date,} i 1._ ,� u „ a;© - p r r a '� u,tt6 IN m':' <br /> 1 i ' r. �. . l <br /> t' I all 1fAtit <br /> .. .4 . m �a .. F #�iY' - ( x'c�y 9i .,•.?"'�' ~ �f* d�.r .k.'r 'ori <br />