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SU0005655
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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PA-0500472
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SU0005655
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Entry Properties
Last modified
5/7/2020 11:31:41 AM
Creation date
9/9/2019 9:03:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0005655
PE
2690
FACILITY_NAME
PA-0500472
STREET_NUMBER
26695
Direction
N
STREET_NAME
RITZ
STREET_TYPE
RD
City
ACAMPO
APN
00313018
ENTERED_DATE
9/27/2005 12:00:00 AM
SITE_LOCATION
26695 N RITZ RD
RECEIVED_DATE
9/27/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\R\RITZ\26695\PA-0500472\SU0005655\APPL.PDF \MIGRATIONS\R\RITZ\26695\PA-0500472\SU0005655\CDD OK.PDF \MIGRATIONS\R\RITZ\26695\PA-0500472\SU0005655\EH COND.PDF \MIGRATIONS\R\RITZ\26695\PA-0500472\SU0005655\EH PERM.PDF
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EHD - Public
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" ANJPLICATION - LOT LI <br /> a . -- E ADJUSTMENT <br /> FILE NUMBER: <br /> '.. .4:AUTMO.R!ZATION Sl6NAT RE3 <br /> ONLY THE OWNER OF THE 0900ERT1-01tANAIN-O' MAY ME AN APPLICATION. <br /> I, the Owner/Agent-Wee, to defe 4 bdemnik and hold harmless the County and Its agents, officers and employees <br /> from any claim,acdbn or proceeft aQalnst the Owner/Agent`s projecL <br /> I,further,certify under penalty of perjury that I am(check one): <br /> Legal property owner(owner Includes partner,trustee, trustor,or corporate officer of theproperty(s) <br /> app�on. ) involved in this <br /> ❑ Leo agent(attach proof of the owner's consent to the application of the properVe Involved in this application and <br /> have been authorized to Elle on their behalf.,and that the foregoing aPPIketlon statements are true and correct. <br /> Print Name' Signature: , <br /> Date i r <br /> NO Name: Signature: tate: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Nam 5 nature• Date: <br />
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