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SU0004146
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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GX-96-04
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SU0004146
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Entry Properties
Last modified
5/7/2020 11:30:32 AM
Creation date
9/6/2019 11:05:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004146
FACILITY_NAME
GX-96-04
STREET_NUMBER
250
Direction
W
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
LATHROP
ENTERED_DATE
5/12/2004 12:00:00 AM
SITE_LOCATION
250 W LOUISE AVE
RECEIVED_DATE
6/28/1996 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\L\LOUISE\250\GX-96-04\SU0004146\APPL.PDF \MIGRATIONS\L\LOUISE\250\GX-96-04\SU0004146\CDD OK.PDF \MIGRATIONS\L\LOUISE\250\GX-96-04\SU0004146\EH COND.PDF \MIGRATIONS\L\LOUISE\250\GX-96-04\SU0004146\PUB REC REL APPL.PDF
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EHD - Public
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APPLICATION - AGRICULTURAL EXCAVATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <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 from any claim,action or i <br /> proceeding against the Owner/Agent's project. <br /> I,further, certity under penalty of perjury that I am(check one): <br /> ❑ Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)involved in this <br /> 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 authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: S}ct,e_tn I\ f✓h ¢-2 Signature: Date: `�Q6 <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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