Laserfiche WebLink
b`J-�b-1y`J( CJ�J•s7!"A'1 ---F.IkLn-• --.a�.r. .•___-. _• .-._ .� �-..0-.•--- -- ,- ~r.=,---'�= /`�-' .. a_.7777,,, <br /> post-IV Fax Nate 7871 <br /> To eA <br /> Goldepl ./N� Co. I 4 ,i i i i'.s I r . :Z <br /> '°"aa rao+lirb8-3'I ES MOW# <br /> Sm. tom) r- aims r 5W-2-2-Z7- <br /> 57 SES' 25 M 10 52. <br /> SAN 0AQUju COUNTY <br /> F PUBLIC HEALTH SERVICES _"< <br /> 6NV'IRONMBNTAL HgALTH DIVISION : <br /> VX18LIC RECORDS RE <br /> LF3ASS APPLICATION <br /> CHOi+H ]NO--L <br /> AAPLICANT e"A-rWADDRESS <br /> iSNCY' 1ai iGP S � IiONS N0 <br /> AG <br /> ADDRBS3 - <br /> F ' tx*lr,t�tt#��rtxaeir#�lr*#**�t�*���#nlr*ir,t**r-Ari,k#rir##x*yf#*'�ttitt#*tttx*��rx•M* *^ <br /> FROG. z <br /> FL,�L ADDRESS tp QE <br /> ILIK <br /> FACILI']�. <br /> 8urc <br /> l f azo �tGm� MI6 — — ccey &&e o <br /> 4a2 Af• ucr -�iw <br /> elLAZ <br /> (1451 <br /> Vie o� �7.t 1 <br /> t <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE:PUSLI FiirALTti <br /> SZ iVICFSIENVIRO�IIVIENTAI.HEALTH DIVISION (E=HD► POLICY 094.007. ORDINANCE CODE�F C <br /> SAM JOADLIIM COUNTY. 1=H1] FEE AND SERVICE CHARGE RESOLUTi0td5, STATE WATER'COI7E, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. ` <br /> t. A MAXIMUM OF TEN jUpAFMISE ADDRESSES PER REQUESTAILY. :` } <br /> ARE PROCESS <br /> 2. PUBLIC FILESIRECORDS REVIEW IS BY QVIriITMEN��dTMENTS!AR SECHEDUL ED MONDAY <br /> ED BY CALLING 1209)"9-3420. OFFICE HOURS FOR <br /> AP <br /> 71-IHU FRIDAY EXCLUDING HOLIDAYS. 8:00 AM TO 12.00 NOON AND 1:00 TO 4:30 PM. <br /> 3. A PUBLIC FILESIRECORDS RELEASE APPLICATION (pLil�41 IS ItIr4EJLFtFD• <br /> =r <br /> 4. PUBLIC FILLSIfIECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED Will BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL HE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94-007).: <br /> S. ORIGINAL PUULIC FILESIRECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. .: I <br /> .. - aras� ��i�♦ifl.farar <br /> � �► <br /> a�rais�+asai1i+��aa•rillrtsrrrlsrrrarrss,rs++r• <br /> am& aar• <br /> DATE <br /> SIGNATURE OF APPLICANT <br /> DATE r' <br /> SIGNATURE OF RELEASING OFFICIAL <br /> EH 00 14 (REV 9/ 81 <br /> .. TOTAL P:01?' ttI <br />