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F _ - 0 ;300 ` 0 <br /> APPLICATION - REVISIONS OF APPROVED ACTIONS <br /> SANJOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �� ai 'Ar: .as, asx� syr z,�, ). :: i=• '� <br /> s• Ct7rfEFEtkBY3HE` N�rE' ft�3t3Fltg[ TFiEAHPLIt`JkT[Olt : «n <br /> Asa ..,r/ <br /> � <br /> -y /Y • ; O %:. l •.n i �- lltia�lt5/1[) Y' ) 3. i ) !' <br /> Name: See Attachment 1 Name:Thom son-H sell En ineers <br /> Address: 1016 12th Street <br /> Address: <br /> Modesto California 95354 <br /> Phone: (209) 521-8986 <br /> Phone: <br /> ".wagiffli <br /> Rwlelon to: <br /> M Condldonis of A roval <br /> FlIe No: PA-03-346 (MS) <br /> Des M edRevlsions• See Attachment 2 <br /> I <br /> I- I <br /> I <br /> I <br /> I <br /> State the facts showin the changes In circumstances which make the sub ect conditions no longer a ro Hate or necessa <br /> See Attachment 3 <br /> i <br /> 7777 <br /> Ai{/ Y W ,fl A { � f� Y iiMYR) Rd" Y^'•�Y, .f .. <br /> ONL�7FI :Cfl1�TN' RCI�% .ply'Q � ���k�r � �`AGENT.MAYFIL�'AN APPI:.ICATION <br /> 1,the owner/Agent agree,to defend, Indemnity,and hold harmless the County and its agents,officers and <br /> employees from any claim,action or proceeding against the Owner/Agents project <br /> I,further, certify under penalty of perjury that I am (check one): <br /> M Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the <br /> property(s)Involved in this application,or <br /> ❑ 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 /> i <br /> PrintNanw: Melinda Gilbeau Signature.. <br /> Print Name: Fred Ballew <br /> Print Namer George Sperry Signature: p( Date: <br /> Print Norm; Marlene Sperry signature: to-, •- — <br /> Print Name: <br /> Scott Rishwain Signature• Data: 7 •`C� �� <br /> -2- <br />