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r <br /> otas�aN � <br /> COUNTY OF SAN JOAQUIN <br /> DEPARTMENT OF PUBLIC WORKS FRITZ BUCHMAN <br /> - „- P.O.BOX 1810- 1810 E. HAZELTON AVENUE Deputy Director <br /> MICHAEL SELLING <br /> STOCKTON,CALIFORNIA 95205 <br /> (209)468-3000 FAX(209)468-9324 Deputy Director <br /> JIM STONE <br /> www.sjgov.org/pubworks Deputy Director <br /> ROGERJANES <br /> Business Administrator <br /> BUILDING PERMIT APPLICATION CLEARANCE FORM <br /> PS-1501937 <br /> APN 055-320-25 QUAD: NW <br /> SITE ADDRESS: 14719N THORNTON RDLODI,CA <br /> SETBACK INFORMATION: <br /> Is the building site near a levee or watercourse:N <br /> (Project must be setback 10 feet from the levee toe or 25 feet fi-om the top of the watercourse bank) <br /> Total Volume of Retention Pond in Cubic Feet: 0 <br /> FLOODIDRAINAGE INFORMATION: <br /> Flood Zone:X5 100-Year Flood Information,Elev 0 or Depth 0 <br /> LJ Finished Floor exempt from 100-Year Flood information <br /> L❑� Drainage shall be retained on-site (Residential) <br /> Total Structure in Square Feet: <br /> PROJECT TYPE CERTIFICATES REQUIRED REMARKS <br /> F] Residential 1. Existing Elevation,cert.(Except AO <br /> Zones) <br /> 2. Elevation Certification. <br /> FX Commercial 1. Existing Elevation,Cert.(Except AO <br /> Zones) <br /> r <br /> 2. Elevation Certification or Flood <br /> Proofing Certification. <br /> Ag.Bldg.,Private Garage Wet Proofing:N <br /> and Storage Bldg. <br /> RESIDENTIAL DRIVEWAYONLY: <br /> Paved or Concrete Driveways)required prior to final occupancy. 1 acknowledge the Driveuay(s)will be paved as <br /> required by the Encroachment Pernal(EP)and inspected by the Department of Pabhc Works prior to the Final Building Inspection. <br /> A TEMPORARY GRAVEL DRIVEWAY APPROACH SHALL BE CONSTRUCTED PRIOR TO STARTING BUILDING CONSTRUCTION. <br /> F1I acknowledge that the existing driveway is paved with Concrete or Asphalt Concrete,therefore an Encroachment Permit <br /> (EP)is not required. <br /> Not Applicable <br /> APPLICANT SIGNATURE-TITLE: DATE: 7Z9 <br /> y / _ <br /> REVIEWEDBY: "� DATE: <br /> "this form determines flood elevation zones and allows plan checking only. I acknowledge that all Public Works Conditions of Approval for the project <br /> (PS-1501937)shall be satisfied. The conditions of approval may take time to process and delay release of Public Works approval,therefore initiate <br /> processing of the Conditions as soon as possible.�'`�' „ <br /> APPLICANT SIGNATURE-TITLE: V'c� TE: S -�� <br />