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Home My WebLink About007-010-037 EHS24-0088 SEPTIC DESTRUCT APPLICATIONON-SITE Date: _ Amount: CONSTRUCTIONP ReceiptNo. Thisapplicationwillbeacceptedwithpaymentofpermitfeeandthepermitwillbeissuedwhensystemdesignissubmitted byaCertifiedDesigner(orCertifiedInstallerforStandardGravitySystem)andapprovedbyEnvironmentalHealth. APPLICATION FormCP 007-010-066APN#: TrakIt#: NorCalExcavating Inc. BillWebb ApplicantName(Pleaseprint) PropertyOwnerName 3668HicksLane 221Sycamore Drive ApplicantMailingAddress ConstructionSiteAddress95973ChicoCA 95973ChicoCA City State Zip City State Zip 530/343-5953ext1 N/A ApplicantTelephoneNumber CertifiedDesigner(ifapplicable) NewConstruction Repair N/A Expansion TankDestruction CertifiedInstaller(ifapplicable) TankReplacementOnly 04/09/2024Residential:Numberofbedrooms: ApplicantSignature DateNon-Residential(specify): DESIGNANDCONSTRUCTIONAPPROVAL Thispermitisissuedbasedonreviewoftheattacheddesignandhasdeterminedthatitmeetsthere- quirementsofButteCountyCodeChapter19On-SiteWastewaterSystems. EnvironmentalHealthSpecialist DateofIssuance Comments/Conditions: Thispermitvalidonlyforinstallationofattacheddesign,stampedApprov Variationfromtheap- proveddesignmusthavepriorapprovalbyEnvironmentalHealth. ThispermitvalidonlyifsystemisinstalledbythehomeownerorbyacontractorwithvalidInstaller CertificationissuedbyEnvironmentalHealth. Thispermitwillexpire2yearsfromthedateofDesignandConstructionapproval. FINALAPPROVALANDCERTIFICATEOF Installationby:Homeowner CertifiedInstaller As-BuiltAttached DesignerSign-off Inspectedby:Comments: EnvironmentalHealthSpecialist Date Update:December14, 2020WhiteEnvironmentalHealthcopyYellowCustomercopy:Finalapproval PinkCustomercopy:Permit 007-010-066BillWebb 221 Sycamore DriveChico95973 NorCal Excavating Inc. NorCal Excavating Inc. - Scott Heyland Septic Tank Demo and Removal Backfill hole with fill dirt 04/09/2024ScottHeyland