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ditN <br /> APPLICATION - REVISIONS OF APPROVED ACTIONS <br /> �2:• -rte r-i. •Z\ <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ( : i <br /> FILE NUMBER: - VAw05001 <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Owner Information Applicant Information <br /> Name: PCCP Mountain House, LLC c/o Lehman Brothers Name: SAME <br /> Holdings, Inc. (Attn: Eric Higuchi) <br /> Address: 3121 Michelson Drive, Suite 200 Address: <br /> Irvine, CA 92612 <br /> Phone: 949-260-4672 Phone: <br /> PROJECT DESCRIPTION <br /> Proposal <br /> Revision to: Map#s 3479,3480, 3670, 3671 Condition(s)of Approval <br /> File No: <br /> 1. Description of the proposed Revisions: <br /> 1.1 Revise tentative maps for all Mountain House Specific Plan III properties owned by Applicant to reflect conditions consistent with <br /> those imposed on property owners within Mountain House Specific Plan ll. See attached map Exhibit. <br /> 1.2 Refine tentative map layout for Neighborhood A-4 as previously agreed to by Mountain House Community Facilities District. <br /> 2. State the facts showing the changes in circumstances which make the subject condition(s)no longer appropriate or necessary. <br /> Not Applicable. <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I, 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 County arising from the Owner/Agent's project. <br /> I, 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 /> have been author e to fjle on their behalf„ and that the foregoing application statements are true and correct. <br /> Print Name: n„rh,,'� C' r�r, Signature: Date: off/ /. <br /> riutho-r,-c v'rgnucory <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature. Date: <br /> F:\DEVSVMPlanning Application Forms\Revisions of Approved Actions.doc Page 2 of 2 <br /> (Revised 05-11-09) <br />