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SU0001195
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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LA-01-37
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SU0001195
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Entry Properties
Last modified
5/7/2020 11:28:30 AM
Creation date
9/8/2019 12:41:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0001195
PE
2690
FACILITY_NAME
LA-01-37
STREET_NUMBER
6095
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
ENTERED_DATE
10/17/2001 12:00:00 AM
SITE_LOCATION
6095 E PELTIER RD
RECEIVED_DATE
6/12/2001 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\P\PELTIER\6095\LA-01-37\SU0001195\APPL.PDF \MIGRATIONS\P\PELTIER\6095\LA-01-37\SU0001195\CDD OK.PDF \MIGRATIONS\P\PELTIER\6095\LA-01-37\SU0001195\EH COND.PDF \MIGRATIONS\P\PELTIER\6095\LA-01-37\SU0001195\EH PERM.PDF
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EHD - Public
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LOT LINE ADJUSTMENT <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 /> 1, the OwneNAgent agree, to defend,indemnify,and hold harmless the County and its agents, officers and employees from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that 1 am(check one): <br /> O Legal property owner(owner includes partner, trustee, trustor, or corporate officer)of the property(s)involved in this <br /> application, or <br /> O 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 rile on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: 6_1 e d/Z 9e Ul;7f-?-pi Signature: Date: -'�� , <br /> Print Name: 4�(0 Qk AD ��A, l . /� Signature: Date:-�9-Q <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> 1'41 PMPA LA98 Feb—ry 1,1999 <br /> _q_ <br />
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