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SU0003590
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MACKVILLE
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28890
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2600 - Land Use Program
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PA-0200191
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SU0003590
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Entry Properties
Last modified
5/7/2020 11:30:04 AM
Creation date
9/6/2019 9:57:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003590
PE
2690
FACILITY_NAME
PA-0200191
STREET_NUMBER
28890
Direction
N
STREET_NAME
MACKVILLE
STREET_TYPE
RD
City
CLEMENTS
ENTERED_DATE
5/7/2004 12:00:00 AM
SITE_LOCATION
28890 N MACKVILLE RD
RECEIVED_DATE
5/9/2002 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\M\MACKVILLE\28890\PA-0200191\SU0003590\APPL.PDF \MIGRATIONS\M\MACKVILLE\28890\PA-0200191\SU0003590\CDD OK.PDF \MIGRATIONS\M\MACKVILLE\28890\PA-0200191\SU0003590\EH COND.PDF \MIGRATIONS\M\MACKVILLE\28890\PA-0200191\SU0003590\EH PERM.PDF
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EHD - Public
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4 <br /> S <br /> Lor LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> i <br /> 1,the Owner/Agenf agree, to defend,Indemnify,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 /> f,further, certify under penalty of perjury that I am(check one): <br /> 4I Legal property owner(owner Includes partner,trustee,trustor,or corporate offker)of the property(s)Involved In this <br /> application,or <br /> t$ Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application and <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: � C,c�e ,r-) Signature: Date: --/_ ch ti <br /> Print Name: anec�Ccyl _ Signature: Date:Print Name: .(A� 7 (� s0� Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> i <br /> i <br /> 1:41 PMPA LA0!Fehuvy 1.1M <br /> -4- <br />
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