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1\J R d AD - TO -C 9 F3") e, <br /> : _ Gr�Ru � � w �- �� �u�i NA-I� � l� �� h 1A �' C� <br /> d1d I w- 6? PnN7 <br /> APPLICATION - REVISIONS OF APPROVED ACTIONS <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> X. <br /> -v <br /> .:5:f; <br /> g"al, <br /> A <br /> "k 01MU—n <br /> r.I I W11 <br /> Name: :b FI l I Name* 0 <br /> Addres!s:GIA 9l.k-b WARAr4A*I/VK MON Address: auLga 1q.Wa1R artqNAMf <br /> - 161of WAGT ilh")E 16 to( W, 6,RA Hr ZA t) E; OA*D <br /> o q 9 r-376 Phone:LAO q f3 e-0 q>I d-A <br /> . ................... ... <br /> M <br /> I Mg, <br /> H <br /> -a <br /> 'M. A W i*'..: -.k ...... <br /> 0:Z�;i X—M <br /> Revision to: 0 44appl r, LOT Conditionts of Applowd <br /> File No —O/ <br /> 1. Description of proposed Revisions: <br /> 123t- pftlhl` ro 9 x Phl—W 1) Tf/11 PZ ff-1-F PA A V-11\1 & LOT <br /> - -F0 TROW'16 Two PRRIZ-IV16� SfPVCrz-V- r_oR -TA(AC 1LS'. 10F 00 <br /> state the facts showing the changes In circumstances which make the <br /> he sublect condition(s)no longer appropriate or necessary. <br /> AA +oAx 6{jauA, L4L�Afk0AcaA, Z&4K Pleaxa" P-&2�c-e �& f��.Z- G oD ad <br /> 0-/W.�iJv,q R&Of- Z& a&Mt. VZ4L&V 7&- 7jQL,-t&whj6P--TA" Td-lr*da&�/J LA� <br /> &74 ofttt-v-ea lez g.V\A4V wzo- LA-) <br /> d Re&c-F- :t&AX*,M PAO-Y "tog-ji,&m ?7k ' <br /> 7,TAy 4a-,t OYL," ,+AA- .dUu-e <br /> dAILL <br /> W�Zg 4Z�A� Tk&(47 7Fbar 1,4 ZP ag <br /> 22A� ka./,e!�Lu <br /> x <br /> 1, 5 <br /> N- 1 <br /> .. .. ... <br /> UR <br /> MAO <br /> E T: N". <br /> Ly <br /> N ER. <br /> 1,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 Owner/Agent's project <br /> 1,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 <br /> property(s)involved in this application,or <br /> 0 Legal agent(attach proof of the owner's consent to the application of the property's <br /> involved In this application and..have been authorized to file on their behalf.,and that the <br /> foregoing application statements are true and correct. <br /> Print Name:-D B <br /> H Signature: <br /> Print Name: <br /> Print Name: ` Slgnature:-- Date: <br /> Print Name: Signature: Date, <br /> Print Name: Signature: Date: <br /> -2- <br />