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4 . �+�� Department of Public Works <br /> Y SAN_JOAQUIN 1%—C( NO <br /> Kris Balaji,Director of Public Works <br /> Fritz Buchman,Deputy Director/Development <br /> Michael Selling,Deputy Director/Engineering <br /> wadring for YOU Jim Stone,Deputy Director/Operations <br /> Najee Zarif,Interim Business Administrator <br /> BUILDING PERMIT APPLICATION CLEARANCE FORM <br /> PS-1701469 <br /> APN 207-200-32 QUAD: SE <br /> SITE ADDRESS:26263E DOVE RDESCA,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 from the top of the watercourse bank) <br /> Total Volume of Retention Pond in Cubic Feet: 0 <br /> FLOODIDRAINAGE INFORMATION: <br /> Flood Zone:X 100-Year Flood Information,Elev 0 or Depth0 <br /> X❑ Finished Floor exempt from 100-Year Flood information <br /> Drainage shall be retained on-site (Residential) <br /> Total Structure in Square Feet: <br /> PROJECT TYPE CERTIFICATES REQUIRED REMARKS <br /> 7X Residential 1. Existing Elevation,cert.(Except AO <br /> Zones) <br /> 2. Elevation Certification. <br /> Commercial 1. Existing Elevation,Cert.(Except AO <br /> Zones) <br /> 2. Elevation Certification or Flood <br /> ProofingCertification. <br /> 7 Ag.Bldg.,Private Garage Wet Proofing.N <br /> and Storage Bldg. <br /> RESIDENTIAL DRIVEWAY ONLY. <br /> ❑X Paved or Concrete Driveway(s)required prior to final occupancy. 1 acknowledge the Driveway(s)will be paved as <br /> required by the Encroachment Permit(EP)and inspected by the Department oJPublic Works prior to the Final Building Inspection. <br /> A TEMPORARY GRAVEL DRIVEWAY APPROACH SHALL BE CONSTRUCTED PRIOR TO STARTING BUILDING CONSTRUCTION. <br /> I acknowledge that the existing driveway is paved with Concrete or Asphalt Concrete,therefore an Encroachment Permit <br /> (EP)is not required. <br /> 171 Not Applicable <br /> APPLICANT SIGNATURE-TITLE: i n DATE: <br /> -77 <br /> REVIEWED BY: ---_'--" DATE: 4. --7 <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-1701469)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: t I t DATE:�0 <br /> 1810 East Hazelton Avenue J Stockton, California 95205 1 T 209 468 3000 P 209 468 2999 <br />