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SU0004320
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MOUNTAIN HOUSE
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24383
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2600 - Land Use Program
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PA-0200393
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SU0004320
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Entry Properties
Last modified
12/4/2019 3:34:51 PM
Creation date
9/6/2019 10:19:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004320
PE
2632
FACILITY_NAME
PA-0200393
STREET_NUMBER
24383
Direction
S
STREET_NAME
MOUNTAIN HOUSE
STREET_TYPE
PKWY
City
TRACY
ENTERED_DATE
5/17/2004 12:00:00 AM
SITE_LOCATION
24383 S MOUNTAIN HOUSE PKWY
RECEIVED_DATE
9/6/2002 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\M\MOUNTAIN HOUSE PKWY\24383\PA-0200393\SU0004320\EH PERM.PDF
Tags
EHD - Public
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APPLICATION - SITE APPROVAL. <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 hbld harmless the County and its agents, officers and <br /> employees from any claim, action orproceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that 1 am(check one): <br /> O Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved in this application, or <br /> Legal agent(attach proof of the owner's consent to the application of the property's Involved in this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements are <br /> true and correct. / �i <br /> Print Name: CC is A L p S; fM A.o C. -- Signature:\ . � �aS��✓� <'�- - Date: � C7 G�,L <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date; <br />
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