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JL ffdl i r%; J0_A dLPj► <br /> AN JOAQUIN COUNTI DEPARTMENT MANNING AND BUILDING INSPECTION <br /> C b..P.N.- <br /> wner's Name_ (V2,11 Lxl 7 ds Sum.nt,-ie <br /> Mdress 3 1— - _ map a <br /> City Zip Phare J _�a3� bl/Iota <br /> Census Tr. � • <br /> pplicant's Name Setback! <br /> F-1 Coniractty C)Owner <br /> -- ---' front <br /> Address <br /> left_ <br /> City— Zip phone - — right t <br /> ecise It-cation of pr"rty__1A_.'f•t`' — rear ! <br /> Yes Nn <br /> �5 - y. -5� ,4�. -- sewers n o <br /> -acture address �AIIIUA - water system <br /> lL —[] (� <br /> op OSed VSe of structure(s) drainage system t <br /> �A�� .. ��w-`� J[ - ` <br /> DRAT! (e)Location of minimum sewage disposal area for septic tank and leach lines <br /> y is) The lot or parcel Involved,showing shape &dimensions (f) Irrigation or drainages ditches,waterways and drainage ponding areas i <br /> (b) Abutting street;and other riot-of-way and/or easements (g)Location of existing and proposed driveways and encroachments <br /> (c) The locations of all existing buliding and distances to lot Ilxs (h) Levees,with the crown shown y <br /> i (d) The locations of existing and proposed septic tanks and wells (1) WITH DOTTED LINES,THE PROPOSED STRUCTURE or ADDITION <br /> + A�North <br /> i. ~•..-•-� �_ J•T� ....__ rte• .1 ~� _._... -_.. y._ t - _.._1-t-. e <br /> drA x <br /> , <br /> / Tree s . f <br /> &1161 <br /> 71 <br /> 4 _._'--�'--__-•�:-:. __�_• ... ALJ e <br /> 7 1- <br /> VIA <br /> - -- ;SCIM Gr, I <br /> .Y <br /> iicant certifies that the property for which the APPROVAL Is sought is dc=ribed as&Love xnt!L`_r_9 existing at tutesAthe property are <br /> vi on the above plot plait. j <br /> Applicant's Signature <br /> UINNINC DIV. 1810 E.Hazelton Avenue • PUBLIC WORKS DEPT. 1810 E.Hazelton Ave. • LOCAL H LTH DISTRICT y ,' <br /> Prope^y mesh zoning reoulrcmt-s rc:win 1.PROPOSAL APPROVED SUBJECT T0: ENVIRONMENTAL HEALTH DIVISION <br /> use and con:Vociion A. Encroachment Permit required Q 1601 E.Hazelton Avenue <br /> Yes 0 No Q Zone B. Surface drainage established as shown C] 1.PROPOSAL APPROVED SU13JECT TO 1 <br /> SPEC,AL CONDITIONS C. Fees A.Obtaining sanitation permit Q <br /> I * A.Sctooi dfsUlct fee— C-, 'a. Connection Fee 0 B.Obtain well/pump permit © <br /> ,- Floodr+ay as shown Q b. Buy-in-fee O C.Change noted Q <br /> :i <br /> n C.Flood fringe Q 2.REMARKS 2.PROPOSAL DENIED Q <br /> 3 D.Noise Impact [] 3.REMARKS k. <br /> PARCEL-MAP NO. date by 1i <br /> i; REIL.RKS date by ;' r <br /> FLOOD CONTROL: date ? <br /> ® BLOC. rru►, r• t•/as <br /> date by +' <br />