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SU0003522
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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PA-0300142
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SU0003522
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Entry Properties
Last modified
11/21/2019 4:35:08 PM
Creation date
9/4/2019 11:03:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003522
PE
2690
FACILITY_NAME
PA-0300142
STREET_NUMBER
29201
Direction
E
STREET_NAME
CARTER
STREET_TYPE
RD
City
FARMINGTON
ENTERED_DATE
5/3/2004 12:00:00 AM
SITE_LOCATION
29201 E CARTER RD
RECEIVED_DATE
4/17/2003 12:00:00 AM
QC Status
Approved
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SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\C\CARTER\29201\PA-0300142\SU0003522\CDD OK.PDF
Tags
EHD - Public
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LOT LINE ADJUSTMENT <br /> EN <br /> RM AGENT MA <br /> 1,the OwnerlAgent agree,to defend,Indemnify,and hold harmless the County and Its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project <br /> 1,further, certify under penalty of perjury that l am(check one): <br /> • Legal property owner(owner Includes partner,trustee,grantor,or corporate officer)of the property(s)Involved in <br /> this application,or, <br /> O Legal agent(attach proof of the owners consent to the applicatlon theprop rty's Involved In this application and <br /> have been authorlrad to file an their behalf.,and that the forgo st marts are true and correct. <br /> 1 <br /> Print NameSignature: . -?:Z7Da <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: l� Signature. <br /> Date: <br /> 1. <br /> { <br /> r <br /> Fe DEVaBR)IUMR/PLANAPP9/IATLIWTAWAPPPORl1 RN 2/3/99 - —4— <br />
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