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SU0001289
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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LA-00-27
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SU0001289
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Entry Properties
Last modified
5/7/2020 11:28:36 AM
Creation date
9/5/2019 10:55:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0001289
PE
2690
FACILITY_NAME
LA-00-27
STREET_NUMBER
21222
STREET_NAME
HANSEN
STREET_TYPE
RD
City
TRACY
ENTERED_DATE
10/18/2001 12:00:00 AM
SITE_LOCATION
21222 HANSEN RD
RECEIVED_DATE
4/11/2000 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\H\HANSEN\21222\LA-00-27\SU0001289\APPL.PDF \MIGRATIONS\H\HANSEN\21222\LA-00-27\SU0001289\CDD OK.PDF \MIGRATIONS\H\HANSEN\21222\LA-00-27\SU0001289\EH COND.PDF \MIGRATIONS\H\HANSEN\21222\LA-00-27\SU0001289\EH TRACK LOG.PDF
Tags
EHD - Public
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r i <br /> LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> i <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY.OR AN AUTHORIZED AGENT MAY FELE AN-APPLICATION. <br /> 1,the Owner/Agent agree,to defend,Indemnity,and hold harmless the County and Its agents,officers and employees from any claim,action <br /> 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 property(s)Involved In this <br /> application,or <br /> I <br /> O Legal agent(affach proof of the owner's consent to the application of the property's involved in this application and <br /> i <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> f <br /> i <br /> Print Nama: mr <br /> I I Signature: <br /> Print Name: -Aki "r !� eki ✓ Signature: � � ,t-� Date: <br /> T- I/ <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> E <br /> i <br /> l <br /> 1:41 PUPA LASE FeCnrery 1,1M <br /> -4- <br />
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