Laserfiche WebLink
PRUIN'' SAN JOAQUIN COUNTY <br />?� ENVIRONMENTAL HEALTH DEPARTMENT <br />• 1868 East Hazelton Avenue, Stockton, CA 95205--6232 <br />ctixBsiN:P Office: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />Request for Compliance Date Extension <br />LOCATION: v ! Sic f CITY: <br />PROPERTY OWNER NAME: f / ` <br />List tasks needed to correct all violations and provide a date the IFwill be completed. In the comments section, pro de specific <br />information describing the task: type of unsafe condition, type of pre -permit activity (i.e. preparation of plans, asbestos survey/utility <br />disconnect for demolition), type of permit needed i.e. local building permit, well or septic permit, State Housing and Community <br />Development permit), etc. Use additional paper, if needed. <br />COMPLIANCE TASK DATE COMMENTS <br />Property/Unsafe Condition Cleanup ////5— �,�ea�, Ala <br />Property/Unsafe Condition Securement <br />Pre -Permit Activities <br />Obtain all Required Permits <br />Repair/Demo Task v / <br />Repair/Demo Task <br />Repair/Demo Task j Sk4ar- <br />Repair/Demo Task <br />Repair/Demo Task <br />Repair/Demo Task <br />Repair/Demo Task <br />Repair/Demo Task _ <br />Repair/Demo Task <br />Repair/Demo Task <br />RepairlDemo Task <br />Final all Required Permits % Z 3/ 13 CIS V/d e. y 3 <br />OWNER STATEMENT: I am proposing the above noted compliace dates to perform each securement, <br />cleanup, repair or demolition task to correct the violations cited in the Notice and Order to Abate. I understand <br />that I am required to obtain any required permits for all repair or demolition work. I understand that the EHD <br />charges an hourly rate for all time spent 9ty this enforcement case. I further understand that failure to comply <br />with these compliance dates may result X Yurther enforcement or abatement actions. <br />�A/V//// ?e-� <br />TUVE OF PROTPERTJ OWNER/AUTHORIZED AGEN PHONE <br />owK /// <br />DATE <br />(APPROVED BY:. <br />EHD 13- `10/22/13 Request for Compliance Date Extension <br />