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APPLICATION - QUARRY EXCAVATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AP_ PLICATION FORM <br /> ICONT/NIfED ¢ x r w rY g <br /> OWNER, OPERATOR AWAPPLICANT INFORMATION AND SIGNATURES <br /> ONLYTHE OWNER OF.THE PROPERTY OR.AN.AUTHORIZED:AGENT MAY,FILE;AW APPLI ATION <br /> Property'owner(s)or.owners ofsurface rlghis(llst`all owners) <br /> Nome: Address: Phone: - <br /> $IgnotYK: :': <br /> Name Address: (hone: <br /> Signature: Date: <br /> Nome: Address: Phone: <br /> Signature: Date: <br /> Name: Address: Phone: <br /> Signature: Date: <br /> Nome: Address: Phone: <br /> Signature: Date: <br /> Note: All Legal owners of the property(s)Involved in this project or their legal agents must sign the application <br /> thereby verifying that the statements contained In the application are true and correct. If a legal agent signs the <br /> application on behalf of the property owner, written consent by the owner must accompany the application. <br /> ( _ .. •:,,::.\ �.1�f �'i'�'i�j^�*' 'i" .HS��j;,3.�,�,a�i�iiM1� T\ b ^Zt r`4� .1 <br /> • . , _Owners of►nlnerat:r/ghis m:,�x`�, t,r , max., :�.. :� :' <br /> Name: Address: r Ph---.2,2 <br /> Nam L: Address: Phone: <br /> y ' Operator <br /> Name: i•l.�y;` ��t, Address: <br /> Address: HtaNR <br /> Na— ' <br /> Agent of process.(person designated by operator as agent fbr;the'sery/ce,process) <br /> Name: Address: Phone <br /> v <br />