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APPLICA"rsilN — REVISIONS OF APPROVED ACTIONS <br /> 2: <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: - �W <br /> �1F01� <br /> "e:;%�vZ <br /> 35PDS C-4WLLht f t/v )Tk ame:f � Address:R ' cl�- ,ri-sr-AQ) <br /> Phone: Phone: y J F57i c� - 52-6. 5� (� <br /> 2 _ <br /> Revision to: t Map Condition(map of Approvw <br /> File No: <br /> 1. Descripti n of the proposed Revisions: F 1712 q 1 ee-T47 t <br /> F B Rt Pao oSe/? PhA-,i f, 1 F o/N LaTbro <br /> 7"&-ua7 f1Ae"4a1yl&A*t,"bs7wr✓c;P <br /> '2,007 - yory8 l Yt c IiA5:f b la000 e9 r7 /.vTrov n lvvaCryr Sv!/Jive ' ye <br /> d - w ;c r <br /> 2. State the facts showing the changes in circumstances which make the subject condition(s)no longer appropriate or necessary. <br /> FtasT NIq £ w n t N A co t� Kuo✓F - Fl�i✓�. <br /> s ON T{dr- EA LAms 6E 7NE a-aia J n/ l/a g- 719 , <br /> Uv� <br /> M f To FinAnLNL /2- J FN c% GEN o WVE /kaEC-T <br /> A SwA 1 As Lt Ike x! zSr-p eiq2478ODs4 FT <br /> a Id1 IEU• 1 L'I"UAA1- li#M IS /N PAEoWtJCm.M <br /> ti ti Tim D/i /! Lf/'vv, gy /JJ c a 1E <br /> � s SGL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> 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, grantor, or corporate officer)of the property(s)involved in <br /> this application, or <br /> Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and <br /> ave been authorized to_fille__on`their behalf., and that the foreaping application statements are true and correct. <br /> Print Name: GpQI +1EI Signature: Dater <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEVSMAlanning Application Fonns\Revisions of Approved Actions.doc Page 2 of 2 <br /> (Revised 10-19-04) <br />