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SR0077570
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0077570
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Last modified
12/3/2020 6:49:59 PM
Creation date
12/3/2020 2:39:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0077570
PE
4211
STREET_NUMBER
26297
Direction
E
STREET_NAME
DOVE
STREET_TYPE
RD
City
ESCALON
Zip
95320
APN
20720032
ENTERED_DATE
5/26/2017 12:00:00 AM
SITE_LOCATION
26297 E DOVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\fgarciaruiz
Tags
EHD - Public
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� 3 <br /> 9870 E.HAZELTON AVENUE, N 95285 <br /> �Q <br /> BUMES8 PHONE. (209)468-3121 <br /> 4qS <br /> / T.41M NOTICE TO PROPERTY OWNER <br /> Dea,rf?t _ <br /> An app( on for a b yp has been.subq&ed in:your par a-fist g,�asthe builder a€ eopeq <br /> improvements specified at <br /> We amprovrd V Y gp9opp4w#der A.dm *ment and o""gn ., iftWoCr eke.�rou <br /> aware of lrorx r t e .l u ay -ha3ru,g Mt <br /> permit u�d a as e <br /> sOf <br /> Wd <br /> wed tts#vrtn to WWM us:a#our o#firiai s indre>3i#ed. A.coy of the <br /> property W-Malred to verityAhe ovniees sWnature <br /> Read and ini",each,st.a.tement belqwto signify You,understand.orverify.-t is information. <br /> ! understand afrequent ice of unlicensed persons is to Have the property owner obtart <br /> buMing permit that errteousty kapfies that the property owner is providing his or her own`W or <br /> mater ra as er be lrable,and subjectoto stews# ancial.- <br /> aoverageax�e l am Y �c!'irr hof <br /> R ti . c6iig ylililder <br /> Wor"on <br /> fi 3, <br /> a as an(�_T e: <br /> > y Ifo workers on my property. <br /> l understd building perms are fiatrequired to be signed by property owners unless they are <br /> , . <br /> _ Ibr1f to4 bmucbw and are not bbrir�a# Conbractor to aswc ne ttf-ie sponsi ty. <br /> 3�. !.u� -as an`Cet--6u�7der"t am the �bte pY of rem on the apem�it;:i �d . <br /> t,x etrtial hn a oen Cor�trrai or a�1-d'having the pe[ lVed in his or- _ Y <br /> harr�rne is my own. <br /> 44- l understand Contractors are required by nbdTlcensedand bonded i afifo a its # r <br /> numbers on permits and contracts. <br /> AbS. I understand if I employ or otherwise engage any persons, other than CaWom Gcens Contractors, <br /> tn+e total a A r €o©strvrtron is:at legit a emacs f$ fit' ��l4AaY <br /> e c�r3srder�ed an`employer'unci state and federal law. =, <br /> 6. l under it afi�co dere�d an`"em under stale andfa4ww law, I ffl It <br /> �:govemment,w hhatd,payrott tw=,provide workers'compensa0dn d iinsurance,and�e <br /> _ _ _.m. __ tad 0 r r also ut�erand r e 40 abiide ft Sr }F <br /> to sedow finandal risk' M <br /> Fstarld under CafforR{a CiOntfdCtOFS'S'tdte #T °` <br /> � laid Cheat I'1 tyle t�0er1s8�._ <br /> arl QWt�r-�_ <br /> and the number of sbucWres does fiat ez IWmm—WiMi any calendar year,or all of <br /> the wxkw= as W&ffoenwd-g+eneralbuRft-Cenftadx.- <br /> . <br /> I <br /> m is I be <br /> .. may Geld Viable <br /> �+ar car it ectbsegt ?fit c er rat wit f m any Mat construction <br /> %Mkrr artship or materials. <br /> l may obtarn more mf<urrr�fion re99 mY OgatiOnS aS an*6*loyerfrom the Internal <br /> 8c Vet6on F�ndoc 9 of 2 <br />
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