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opo to CHECK LIST - DEMOLITION PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVENUE, STOCKY -Gjk95205 <br /> 1 BUSINESS PHON 209) 4684121 <br /> �'• — tP INSPECTION REQUEST 24-HOUR RECORDER: ( ) #468--3-169 <br /> ql%FORS <br /> CHECKLIST <br /> THE FOLLOWING INFORMATION AND DOCUMENTATION MUST BE SUBMITTED TO DEVELOPMENT SERVICES Check- <br /> BEFORE YOUR APPLICATION CAN BE PROCESSED. Off <br /> 1. One completed Application. <br /> 2. Obtain Environmental Health Department Approval on Demolition Permit Application. The final <br /> disposition of the well and septic system must be identified prior to application approval. <br /> 3. If your demolition project is 1200 sq. ft. or more you must obtain an approved Debris Diversion <br /> Plan from Public Works Solid Waste Division office at 1810 E. Hazelton Ave., Stockton,468-3066, <br /> PRIOR to obtaining your Demolition Permit. <br /> 4. Obtain Air Pollution Control District Approval on Demolition Perm-it Application. <br /> 5. It is the applicant's responsibility to notify P.G.&E. and have utilities disconnected. It is also the <br /> applicant's responsibility to insure P.G.&E. notifies the Buil ' spection Division ese <br /> utilities have been properly disconnected. Please contact P.G. E. at(209) 942-1526. <br /> Scope of Work: V Av6L(2 6�vwa S — d--_ <br /> Project Address: 11ooI Eo oo 1- kkAAA Lz-& <br /> DEPARTMENTS LISTED BELOW MUST GlVg APPROVAL PRIOR TO ISSUING DEMOLITION PERMIT <br /> Environmental Health Department Approval Signature: + �t Date Issued: '5 2� l4 <br /> San Joaquin Valley Unified Air Pollution Control Date Issued: <br /> District Approval Signature <br /> AIR POLLUTION CONTROL DISTRICT ENVIRONMENTAL HEALTH DEPARTMENT <br /> 4800 Enterprise Way 1868 E Hazelton Ave <br /> Modesto, CA Stockton, CA 95205 <br /> 557-6400 (209)468-3420 <br /> FMpplication Forms&Handouts\Check lists\Check List Demolition Permit.doc(Revised 1-11-11) <br />