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SU0008832
EnvironmentalHealth
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2600 - Land Use Program
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PA-1100125
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SU0008832
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Last modified
5/7/2020 11:33:42 AM
Creation date
9/8/2019 12:41:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0008832
PE
2622
FACILITY_NAME
PA-1100125
STREET_NUMBER
4330
Direction
W
STREET_NAME
PELTIER
STREET_TYPE
RD
City
LODI
Zip
95240
APN
01302001
ENTERED_DATE
7/22/2011 12:00:00 AM
SITE_LOCATION
4330 W PELTIER RD
RECEIVED_DATE
7/21/2011 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\P\PELTIER\4330\PA-1100125\SU0008832\REV EH COND.PDF \MIGRATIONS\P\PELTIER\4330\PA-1100125\SU0008832\APPL.PDF \MIGRATIONS\P\PELTIER\4330\PA-1100125\SU0008832\CDD OK.PDF \MIGRATIONS\P\PELTIER\4330\PA-1100125\SU0008832\EH COND.PDF
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EHD - Public
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w <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <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 mold harmless the County and its agents,officers and employees from any claim, <br /> action or proceeding against the County arising from the Owner/Agent's project. <br /> I further certify, under penalty of perjury,that I am(check one): <br />! ® Legal property owner(owner includes partner,trustee,grantor, or corporate officer)of the p perty(s}' volved in this <br /> application,or <br /> I <br /> El Legal agent(attach proof of the owner's consent to the application of the property's involvyed i is application and have been <br /> E authorized to file on their behalf., and that the foregoing application statements are true a?� orrect. <br /> I <br /> I <br /> Print Name: Andy C.Alexander Signature: /t Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> F:1DEVSVS%Planning Application FormslMinor Subdivision(Rev.05-11-09) Page 7 of 9 <br />
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