Laserfiche WebLink
SITE IMPROVEMENT PLAN <br /> a •�o <br /> L %A <br /> :'< SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> it <br /> c FILE NUMBER: IP- <br /> [fro�`� <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> �- S. Bird Road Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> j, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the County arising from the Owner/Agent's project. <br /> f,further, certify under penalty of perjury that I am (check one): <br /> Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> 5� Legal agent (attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> #rint Name: Kevin Torell, AICP Signature: Datex 3 <br /> PSint Name: Signature: Date: <br /> i, <br /> . Mint Name: Signature: Date: <br /> �rint Name: Signature: Date: <br /> y , <br /> ;(?tint Name: Signature: Date: <br /> s <br /> F` I <br /> :bEVSVC\Planning Application Forms\Site Improvement Plan. Page 4 of 9 <br /> u /avised 511-09) <br />