Laserfiche WebLink
SAN J OA Q U I N Environmental Health Department <br /> COUNTY <br /> Greatness yrovvs <br /> COMPLIANCE SCHEDULE AND AGREEMENT <br /> LOCATION: AN ' son AM 2 3 P rn RA CITY: T r 1, r <br /> PROPERTY OWNER NAME: l/ <br /> List activities needed to correct all violations and provide the date the activity will be completed. Provide additional specific <br /> information describing the activity:type of unsafe or unsecured condition,type of pre-permit activity(i.e.preparation of <br /> plans, asbestos survey/utility disconnect for demolition),type of permit needed (i.e. local building permit,well or septic <br /> permit,State Housing and Community Development permit), etc. Use additional paper if more space is needed. <br /> COMPLIANCE <br /> COMPLIANCE ACTIVITY. DATE FULL DESCRIPTION OF ACTIVITY <br /> Unsafe Condition Securement <br /> Pre-Permit Activities <br /> Obtain all Required Permits t f 4; ju),() o9 i-Gt is ac f ?e r to'4 1f niec..eg-a1 �•� . <br /> Repair/Demo Task I (� Y�c'C�►n lqp f s . <br /> Repair/Demo Task <br /> Repair/Demo Task <br /> Repair/Demo Task <br /> Repair/Demo Task <br /> Repair/Demo Task <br /> Final all Required Permits 12,��,ZLZ� Lor'ty-0.it roof f eAOOLL(- <br /> As the owner of the property, or authorized agent of the property owner, I do hereby agree to comply with the <br /> abatement schedule noted above to resolve the violations cited by the Environmental Health Department. 1 <br /> understand that if these activities are not completed by the dates indicated, administrative fines/penalties may be <br /> imposed and additional enforcement actions may be taken, including referral to the District Attorney's Office. <br /> SIGNATURE OF PROPERTY OWNER/AUTHORIZED AGENT: PHONE: <br /> U G - 21 <br /> TITLE: DATE: <br /> (EHD USE ONLY) <br /> NOTICE AND OnERToABATE DATE: 2 n G1 ;` f4W <br /> APPROVED BY: _1 G G(� DATE: r 't 0 <br /> EHD 1300 WX 9-2018 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />