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- <br /> *`�ATION Applicant's Name el' '4 Assessor's Parcel No. <br /> for ED Contractor Cj Authorized Agent <br /> book �-7' Z <br /> &AL Address fr.'iri• .. v <br /> r <br /> r page—`:2 <br /> for City - �7 �' i�fir" `�^"� phone parcel. <br /> CONSTRUCTION O.,,er's Name 19r> lit Y/i`r <br /> in / rss 4f r..r Subd. <br /> Address ` //�•.5 r/c .c,c K,!!_. <br /> UnitSon Joaquin County ella: c <br /> y � <br /> phone <br /> block Of <br /> Precise location of property �'� %�r':!J - - ^�d /1 lot a <br /> G 1. Yes No <br /> Structure address 2, fi G�fly1.U.r.,'� �,i ,��Cr; f r.x 17�'2 � sewers 171 r_, <br /> water system—C:3 C <br /> Proposed use of structure(s) " 7 — , drainage system <br /> DRAW e7 Locatlrin'ai m nimdm Sewiji-tH posal area for septic tank and leach lines <br /> �1 The lot of parcel involved,showing shape&dimensions f�4(f1 Irrigation or drainages ditches,waterways and drainage ponding areas <br /> 4(15! Abutting streets and other right-of-way and/or easements y (g►Location of existing and proposed driveways and encroachments <br /> .(c)The locations of all existing building and distances to lot line;[/4(h)levees,with the crown shown <br /> ,'(dh The locations of existingand proposed septic tanks and wells (i)WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> - r <br /> _. ., F. <br /> — <br /> - -�-f-t-�-- - <br /> 417�- <br /> - t <br /> ' —•— -moi- �'"_ _ t'—_ + --- - � � <br /> --� � -- =—77— x <br /> .. . — - _ <br /> - — <br /> Ir <br /> : <br /> --- r <br /> Appeoa~Sois L22 0. <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. f' <br /> Date <br /> Applicant's Signature rT' <br /> •PLANNING DIV, 1810 E.Hazefton Avenue •PUBLIC WORKS DEPT. 1810 E.Hazelton Ave. •LOCAL HEALTH DISTRICT <br /> F.Property meets zoning requirements for both 1.PROPOSAL APPROVED SUBJECT TO: ENVIRONMENTAL HEALTH DIVISION <br /> use and construction -- -, A. Encroachment Permit requir ftt� 1601 E.Hazelton Avenue <br /> Yes 7:] No 0 Zone:7ZJ ' B, Surface drainage established as shown as 1.PROPOSAL APPROVED SUBJECT TO: <br /> 2.SPECIAL CONDITIONS C. Fees A.Obtaining sanitation permit W <br /> A.School district fee p a. Connection Fee [] B.Obtain well/pump permit 0 <br /> B. Floodway as shown p b. Buy-i -lee O C.Change noted C'] <br /> C,Flood fringe 2.REMARKS 2.PROPOSAL DF�JVt€D <br /> D,Noise impact t' ti. L a,r(e <br /> 3.PARCEL IAP NO. date !_ $.R_S 3.R Rly ills' <br /> C REMARKS 'r '.:• �.' r <br /> t tlaq <br /> = ,,,: r ...��`• FLOOD CONTROL: date by <br /> date _by by 111 0606.INsp. 14 40 Fi <br />