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Plot Plan Application <br /> SAN J_OAQUIN COUNTY DEPARTMENT OF PLANNING AND BUILDING INSPECTION <br /> A.P.N. <br /> Owner's Name x> Subd.name <br /> Address map# <br /> City Zip phone bl/lot# <br /> Census Tr. <br /> Applicant's Name Setback: <br /> [] Contractor � Owner <br /> Address 3.3CiLj c Ay-a u:- front <br /> left <br /> City Zip phone right <br /> --_^— <br /> Precise location of property rear <br /> Yes No <br /> sewers C] 0 <br /> Structure address water system [] <br /> Proposed use of structure(s) 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 /> r <br /> ,Pour Pea <br /> , <br /> ort <br /> 1 <br /> cs <br /> N$ � <br /> ,. X illi <br /> t �M <br /> II <br /> t <br /> o _ <br /> wi- <br /> _ • � <br /> ' fI <br /> Fr <br /> N <br /> { <br /> 8 <br /> _... t <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. <br /> Date Applicant's Signature <br /> • PLANNING DIV. 1810 E. Hazelton Avenue • PUBLIC WORKS DEPT. 1810 E. Hazelton Ave. • LOCAL HEALTH DISTRICT <br /> 1. Property meets zoning requirements for both 1. PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction A. Encroachment Permit required 1601 E. Hazelton Avenue <br /> Yes [_�] No = Zone B. Surface drainage established as shown 1. PROPOSAL APPROVED SUBJECT TO: <br /> 2. SPECIAL CONDITIONS C. Fees A. Obtaining sanitation permit <br /> A. School district fee 0 a. Connection Fee 0 B. Obtain well/pump permit 0 <br /> B. Floodway as shown 0 b. Buy-in-fee [] C. Change noted [� <br /> C. Flood fringe 2. REMARKS <br /> 2. PROPOSAL DENIED 0 <br /> D. Noise impact � - j r- :•rr. �-- <br /> 3. PARCEL MAP N0. t 3. REMARKS <br /> date `,� — � by '`, �,..`��.... <br /> 4. REMARKS ; r Aid`v date b <br /> FLOOD CONTROL: date�_u y <br /> date--by by -2 BLDG. INSP. 14 (5/93 <br /> Plot Plan Valid Until ��X/ Si A"e,14 AGli,V,X,L, <br /> 10,0Z i or�� <br /> —. /!•5,, �r :. <br />