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88-2957
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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575
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4200/4300 - Liquid Waste/Water Well Permits
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88-2957
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Entry Properties
Last modified
12/9/2019 10:37:21 PM
Creation date
12/4/2017 9:38:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
88-2957
STREET_NUMBER
575
Direction
S
STREET_NAME
DAWES
STREET_TYPE
AVE
City
STOCKTON
SITE_LOCATION
575 S DAWES AVE
RECEIVED_DATE
11/07/1982
P_LOCATION
CASEY JONES
Supplemental fields
FilePath
\MIGRATIONS\D\DAWES\575\88-2957.PDF
QuestysFileName
88-2957
QuestysRecordID
1712248
QuestysRecordType
12
Tags
EHD - Public
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� f k <br /> ' AUTHORIZATION FOR''APPLICATION FOR PERMITS ) <br /> ` -BY OTHER THAN OWNER OR LICENSED CONTRACTOR <br /> 4 t . <br /> TO:, San Joaquin County , <br /> Departmentlof Planning and <br /> + Building. Inspection <br /> 1810 E. Hazelton Avenue <br /> Stockton, CA 95205 <br /> Phone` ( 209) 944-3701 <br /> I, as. the owner of the property, understand or. have been <br /> informed that the application for a Building, Plumbing and/or <br /> Electrica.l ' Permit .'must be signed by the owner .of the <br /> aroperty, his duly authorized agent or a. licensed contractor. <br /> k. <br /> I am also' awarerthat .I may .designate a third party, such as• a <br /> tenant or person in my 'employ, to sign the application for a <br /> permit on- my behalf. I understand that that person 's only <br /> responsibility or function is to acquire a permit on- my <br /> behalf: <br /> I am aware that the responsibility for the construction and <br /> compliance to codes and 'ordinarices is entirely mine and I <br /> agree to ,accept the, same. 4 <br /> _ Therefore, as the owner of the property located at <br /> Stockton, CA � <br /> • (address)) <br /> r <br /> I do hereby authorize F �= <br /> r <br /> Y . F name <br /> to obtain a. in my name by affixing <br /> (type ;of rmit <br /> name followed by hisi,or her signature on the application <br /> f f , <br /> -for Gr <br /> ., (type/of permit <br /> OWNER'S'. -SIGNATURE Y T ' <br /> OWNER' S' ADDRESS ' <br /> OWNER'S PHONE NUMBER DATE Ll <br /> b <br /> . 8 s <br />
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