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APPLICATION - QUARRY EXCAVATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> APPLI CAT10111 FORMS <br /> �e ,..w,v-•�` fsg "i,;' <br /> . .. <br /> -CON77NI�E0 <br /> OWNER, OPERATOR.AND,A N AND'SIGNATURES <br /> ONLY.THE OWNER OF,:TNE PROPER7Y,OR AN AUTHORIZED'AGENT,kA YFILEAIV APPLIt.:A7ION.�� <br /> 11. ATF 4 -.y»�'s1. #�.:w4 "�'�',h�A.F Asm�$p-,Y� Mt Y.�T{ <br /> Property'owner(s) nownery surfs rights(hst.all`owners) <br /> vhan[: <br /> Name: Afdress: <br /> SlgnaWn: Date: <br /> Name: Address: Phone: <br /> Slgnotare: Ooze: <br /> Nerve: Ad/rest: <br /> Phonc <br /> Slgnarure: <br /> Dat[: <br /> Nom[: Address: Phone: <br /> ".9—f...: Dot[: <br /> Name Address: Phone: <br /> Siff—r—c 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 /> MYL" <br /> ,. Own'ers of mineral rights ,. '�wr S .. <br /> � <br /> Address: r Phone:24,2 <br /> Namc / - �t <br /> Mamr. Address: Phan.: <br /> k rP y. a i"f"1f. �TP4 'yyb'•"a' 7 - 3 t! <br /> fY r a Operator <br /> Addrert: �J �? .. :.it V'? �i- It °v�ibSla.et <br /> Nome: Address: � - Phone: <br /> Agent of process,(person designated by operator;os.dgent,for the servlce,pr'ocess) , irr �r� <br /> Namc Address: Phan[ <br /> f <br />