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From Crn-ri rca 2RO <br /> 7 16. <br /> r <br /> SjjoAoUIN COUNTY <br /> FUIFITTC. HEAT,'rli SER110ES <br /> V()aLjC RECORDS RIEL.CASE APPLICAITTONi, <br /> PHONE N <br /> D PT,T r-MIT_ e�7 a, <br /> -- <br /> HONE "No: <br /> NAI <br /> AGSNCY <br /> ADDRESS <br /> t 'i Ir A_.J. k A i <br /> A • 4, 4, .6 4 '6 4 A- 17 6t I'111,1 ¢ <br /> i? <br /> a u s <br /> 77 <br /> r <br /> 51 <br /> -z f4 <br /> 4 a 4 4 L L 4 4 1l 4 1 It <br /> HEALT1 I CIV.ICION 1,0101 POI,.'Cy ;rOt nO" <br /> Op CODE I'D f- <br /> SAN J(JAQUIN COVNTY, F-HO 5EE AMD SERVICE CHARGE RESOLk-ITIONS, STATF: WA"lVF? <br /> GOVERNMENT CQ0_ AE AND THF7 F7V1r)FNf,-F- COf-Jr. <br /> I. A MAXIMUM. Or IM Ltpl MCMISC AODt-,r--..-,--. PER RECUE5T <br /> 2. PUBLIC r-ILE!3iRF_C.QK0S REVIEW 13 BY ehEF_Qjr1TrwiK[v:T QULY. APPOINTMENTS Af;E -M3C--_-C%;:3- <br /> CO BY CALLING 120 468-3424- OFFI.CE HOURS Fort APpOINTNA.ZUST S ASESCHEr.11t,"LED MCNnAY <br /> THrtU MIDAY EXCLUCING HOUDAYS, 3:00 Mv'. TO T 2;00 NOON MUM 1-00 TO 4.30 FNl. <br /> 3. A PUBLIC F1LE3iRECQP.0$ RELEAGE APPLICATION IPRF.A) 15 REQUMEO' <br /> ii I <br /> A' <br /> 4 -'run, 'ONCI 1_10 N' RCCLIV17r, 0[ <br /> . PUBLIC !1LC-5,1,rCCMK; NOT SL xv !r4 1.1 IC "A'"L: 1_"l' <br /> Cr AP t I G A Q c I T 1 r_1 L <br /> )PERECTED BY THE ENO ST AT THE EXPENSE Or Tf IE rUCANT, T <br /> "FnVICr- INILL BE 33ILLED TO T1-)15 ArN,ICANT r0n PAYNJEJIT. JsEr; [.:-I?0 VOL!C:% ill- 007) <br /> S. ORIGINAL ruBLtc rILISMICOROG aI IALL NOT BE SLMUVEL) Mum Ii I IL Utl r n L rv,,r,�c e. <br /> .... ..........4.. . ....... ....... ....... .. . .. . . ... .... ....... .. . . . <br /> "'IGNATURE or APPLICANT DA E <br /> *1f:f`,JATURE- nPATr <br /> . F QF-1-FASING OFFICIAL <br /> EH 00 14 (REV 9195) <br />