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SU0003537
EnvironmentalHealth
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2600 - Land Use Program
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PA-0200599
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SU0003537
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Entry Properties
Last modified
5/7/2020 11:29:59 AM
Creation date
9/6/2019 10:38:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003537
PE
2690
FACILITY_NAME
PA-0200599
STREET_NUMBER
24830
Direction
N
STREET_NAME
KENNEFICK
STREET_TYPE
RD
City
ACAMPO
ENTERED_DATE
5/3/2004 12:00:00 AM
SITE_LOCATION
24830 N KENNEFICK RD
RECEIVED_DATE
12/16/2002 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\K\KENNEFICK\24830\PA-0200599\SU0003537\APPL.PDF \MIGRATIONS\K\KENNEFICK\24830\PA-0200599\SU0003537\CDD OK.PDF \MIGRATIONS\K\KENNEFICK\24830\PA-0200599\SU0003537\EH COND.PDF \MIGRATIONS\K\KENNEFICK\24830\PA-0200599\SU0003537\EH PERM.PDF
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EHD - Public
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r. . <br /> LOT LINE ADJUSTMENT <br /> — SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONL Y TI LE OWNER OF I IIE MOPERI Y OR AN AU111OPIM)AGENT MA Y 1•ILE AN ArrLICA TION. <br /> 1,ihr. (3wner//lgrrrf agree, to defend,indemnify,and hold harnifess the County and Its agents, officers and employees front any claim,ncfion <br /> or proceeding against fire OwnerlAgent's project. <br /> I,farther, certify under penalty of perjury that I am(check one): <br /> a Legal property owner(owner Includes partner, trustee, trustor,or corporate offfeer)of file property(s)Involved In th <br /> appllcato►h, or <br /> 0 Legal agent(atfnch proof of file owner's consent to the applicafion of(fie property's Involved In flits application am <br /> have been authorized to Elle on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Marlin: (f1�O -7--- Signature: <br /> Date: �Q2� <br /> i <br /> Print Name; _ Signature: <br /> Date: <br /> Print Name: Signature: <br /> Dale: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Slgnafure: <br /> Date., <br /> 1:11 PMPA-tA§6 February 1;1988 <br /> 4- <br />
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