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SU0004173
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PELTIER
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15004
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2600 - Land Use Program
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GX-88-01
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SU0004173
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Entry Properties
Last modified
5/7/2020 11:30:32 AM
Creation date
9/8/2019 12:40:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004173
FACILITY_NAME
GX-88-01
STREET_NUMBER
15004
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
ENTERED_DATE
5/12/2004 12:00:00 AM
SITE_LOCATION
15004 E PELTIER RD
RECEIVED_DATE
3/4/1988 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\P\PELTIER\15004\GX-88-01\SU0004173\APPL.PDF \MIGRATIONS\P\PELTIER\15004\GX-88-01\SU0004173\CDD OK.PDF \MIGRATIONS\P\PELTIER\15004\GX-88-01\SU0004173\EH COND.PDF
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EHD - Public
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ti r .\ I'• <br /> I certify under penalty of perjury that I am (check one ) : <br /> Legal Owner (s ) (All owners must sign as their names appear on the <br /> deed. ) , <br /> corporate Officer (s ) empowered to sign for the corporation, <br /> Owner ' s legal agent having Power of Attorney for this action (a <br /> LJ <br /> notarized Power of Attorney document must accompany the <br /> application ) , <br /> and at the fore of is true and corn <br /> (Signature ) (Date ) <br /> 47 <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> s <br /> t <br /> Gin`a'U <br /> ( 7/84 ) <br /> Excavation - 14 - <br />
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