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SU0007049
EnvironmentalHealth
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2600 - Land Use Program
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SU0007049
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Last modified
5/7/2020 11:32:51 AM
Creation date
9/9/2019 9:03:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0007049
PE
2622
FACILITY_NAME
PA-0800070
STREET_NUMBER
1580
Direction
N
STREET_NAME
REPORT
STREET_TYPE
AVE
City
STOCKTON
APN
14315011
ENTERED_DATE
3/18/2008 12:00:00 AM
SITE_LOCATION
1580 N REPORT AVE
RECEIVED_DATE
3/17/2008 12:00:00 AM
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\R\REPORT\1580\PA-0800070\SU0007049\APPL.PDF \MIGRATIONS\R\REPORT\1580\PA-0800070\SU0007049\EH COND.PDF \MIGRATIONS\R\REPORT\1580\PA-0800070\SU0007049\EH PERM.PDF \MIGRATIONS\R\REPORT\1580\PA-0800070\SU0007049\CORRESPOND.PDF
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EHD - Public
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�q ui(y <br /> APPLICATION - MINOR SUBDIVISION <br /> r: z <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> J FILE NO: MS- <br /> ..CQ`FOR�`4 <br /> - AUTHORIZATION SIGNATURES <br /> �-MAL <br /> 1114112-11PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> "s .. h <br /> I,the Owner/Agent agree,to defend, indemnify, and hold harmless the County and its agents,officers and employees from any claim, <br /> action or proceeding against 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 property(s)involved in this <br /> application,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf.,and that the foregoing application s Cements are true and correct. <br /> Print Name:�3-�`��f � �� Signature: Date: 2 -� <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: _ _ Date: <br /> Print Name: Signature: Date: <br /> F:IDEVSVS%Planning Application FormsWinor Subdivision(Rev.12-09-04) Page 7 of 9 <br />
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