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APPL (2)
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CALIFORNIA
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4501
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LA-01-36_LA-01-56
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4200/4300 - Liquid Waste/Water Well Permits
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APPL (2)
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Entry Properties
Last modified
7/28/2020 2:34:25 AM
Creation date
12/4/2017 3:57:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
PE
2690
STREET_NUMBER
4501
Direction
W
STREET_NAME
CALIFORNIA
STREET_TYPE
AVE
City
TRACY
APN
21315009 10 15 16
P_DISTRICT
005
PA#
LA-01-36 LA-01-56
DOC_TYPE
2
Supplemental fields
FilePath
\MIGRATIONS\C\CALIFORNIA\4501\LA-01-36_LA-01-56\APPL.PDF
QuestysRecordID
1676039
Tags
EHD - Public
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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> . ....................... . . . ..... <br /> ...................... <br /> ................... <br /> W:--AFPVCA. <br /> ON. ERVF� fRaREM.:......A VAUVORM <br /> ..y T.-H.I.,IF,Q%"W. PTt#F.. <br /> M VR: <br /> ................. ............ .. <br /> SIGNATURE. I certify under penalty of perjury that/am(check one): <br /> E3 Legal property owner(owner includes partner, trustee, trustor, or corporate officer)of the property(s) <br /> involved in this application, or <br /> )�Legal agent(attach proof of the owner's consent to the application)of the owner of the property(s) <br /> involved in this application and have been authorized to file on their behalf,and that the foregoing <br /> application statements are true and correct to the best of my knowledge and belief. <br /> Print Name: Ken Kjeldsen Signature: Date: 712512001 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name Signature: Date: <br /> Print Name: Signature: Date: <br />
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