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onQu�N n <br /> 1 <'� COUNTY OF SAN JOAQUIN STEVEN WINKLER <br /> DEPARTMENT OF PUBLIC WORKS Deputy Director <br /> �/ P.O. BOX 1810- 1810 E.HAZELTON AVENUE MIKE SELLING <br /> dfi .......:l Deputy Director <br /> STOCKTON,CALIFORNIA 95205 <br /> THOMAS GAU (209)468-3000 FAX(209)468-9324 FRITZ BUCHMAN <br /> Director www.sjgoy.org/pubworks Deputy Director <br /> ROGER JAMES <br /> Business Administrator <br /> BUILDING PERMIT APPLICATION CLEARANCE FORM <br /> PS-1201664 <br /> APN 185-020-08 QUAD: SE <br /> SITE ADDRESS: 78575 NELSON RDSTOC,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 /> FLOOD/DRAINAGE INFORMATION: <br /> Flood Zone:X 100-Year Flood Information,Elev 0 or Depth 0 <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 /> �X 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 /> Proofing Certification. <br /> 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. I acknowledge the Driveway(s)will be paved as <br /> required by the Encroachment Permit(EP)and inspected by the Department of Public.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. ith Concrete phalt Concrete,therefore an Encroachment Permit <br /> (EP)is not required. <br /> Not Applicable �7 <br /> APPLICANT SIGNATURE-TITLE: DATE: <br /> REVIEWED BY ' II \`Y^�'— Cil _ DATE: <br /> This form determines flood elevation zones and allows plan checking only acknowledge that all Public Works Conditions of Approval for the <br /> project(PS-1201664)shall be satisfied. The conditions (approval in, <br /> a time to process and delay release of Public Works approval,therefore <br /> initiate processing of the Conditions as soon si / - <br /> APPLICANT SIGNATURE-TITL �Cf DATE: <br />