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CTE • 209 551 3591 Lou/yo V7:uo LT :uclui IVV.J77 <br /> %/Xe / e vl e w <br /> Lll 00 L3 (It1LV 5194) SAN JOAQUIN COUNTY <br /> PUBLIC 11VAL'I'll SKRVICI"S <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECOILllS RL,"LEASE APPLICATION <br /> APPLICANT <br /> PHONE NO <br /> AUDKMS �C�k4 L]�_k 4 '- d�+� PklOi 8 NO 7 <br /> AG NCY NAME <br /> ADDRMS <br /> FILE A17�. �� DAa <br /> \ n .n 1 n•n �,t�Ya <br /> A min i1n O() <br /> 01__....Al , ase to dra)ci>ia5�•- <br /> r1{1- o,VL <br /> 71113 NO'I1CG I9 SllU1lCP 7O 77111 itCQUIRIIMCN,I-q IDL-N77P18LU IN '1'1111 PUBUC )IEAL;IN <br /> SLiRVICCS/pNVIRONMCNTALIIIlAL17I DIVISION (CITU) PoUCY#94007, ORDINANCSCODtlOP SAN <br /> JOAQUIN COUNTY, LUD P11119 AND VMVICII CIIAR(111 RGSOLU'17ON3, Sfh'1'G wA7Rlt CODU, <br /> OOvGRNMRNT CODII AND'M111 13VIL)PNCtl CODC, <br /> I. A MAXIMUM UPIPN (19) PRIMIaR ADUXRS3111 MR R¢QUENI" <br /> .r,nnrwrr'M N Y. APPOIKWVRte AR¢ABRANdbp by <br /> 2. PUBLIC PII,4S/RCCORUS(tr'"'W u by APP . r—�' 1_Q 1' <br /> CALIANO (709)468-0340. rAM lIl 12:00 M APF1oIKMftNTf <br /> AND 110 PM Al n A IPM.UL¢O MoNnAY Tartu PRIUAY <br /> LXCLUDINO IIOLIUAYS, S:VO <br /> 3. A PUBLIC R¢CORUa R¢LBASB APPLICAIDUN (PRRA)Is RI gUIR¢D. <br /> 4. PUBLIC PIt.I?3/IIIiCORDS POI' R¢rURNBD IN TIIB IAMB CONUILION AS R¢CPIV¢U WILL RB CORRUCIM <br /> by Ill¢ 01111 STAN' AT TIIB DXVEMB Op TIM APPLICANT. 1113 AbDC110NAL SBRVICN WILL 111; BILLED 70 T119 <br /> APPLICANT FOR PAYMENT. (S¢B 611D POLICY 94-007) <br /> 5. URIOINAL PUBLIC PILM(RBCORDS WALL NOT bR RBMoV¢D FROM rile WE) PREM1SPS' <br /> SIONATURtl OC APPUCANI <br /> DATA <br /> glo"ATUItLOP I(EL4ASINO OFPICIAL UA'Ptl <br /> NO PNS/CI IU RECORDS/PILG9 ARB !D¢NTIME()! u... <br /> rr..• �..rw..rr.n <br /> PIIS/13 RECORb�S/1'Il.ra PXISr()N TION AUUR¢SADS)NOT111), YOU WILL b6 IIOTIFiFD WIIBN <br /> ItpconnS/PILRS ARF AVAILA13113 FON NRyIFW: �ro•. <br /> U.vr r.w..•..n <br />