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APPLICATION - REVISIONS OF APPROVED ACTIONS <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: - _- <br /> '9tT�a'c!t' <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Owner Information Applicant Information <br /> [Address: <br /> ame: Brown' s Lake Ranch Name: R. J.M. Enterprises Inc . <br /> Attn. Mr. Ron McManis Address: Attn: Mr. Ron McManis <br /> 18700 E . River Rd. 18700 E. River Rd. <br /> Phone: Ripon, CA 209 599-1186Phone: Ripon, CA ( 209) 599-1186 <br /> 95366 PROJECT DESCRIPTION 953 <br /> Proposal <br /> Revision to: UP-98-0001 Map Condition(s)of Approval <br /> File No: <br /> 1. Description of the proposed Revisions: <br /> See attached. <br /> 2. State the facts showing the changes in circumstances which make the subject condition(s)no longer appropriate or necessary. <br /> See attached. <br /> fAUTHORIZATION SIGNATURES <br /> o <br /> LY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> any claim,action or proceeding against the Owner/Agent's project. <br /> I,further, certify under penalty of perjury that I am (check one): <br /> XLegal property owner(owner includes partner, trustee, grantor, or corporate officer)of the property(s)involved in <br /> this application, or <br /> Ll 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 file on their behalf., and that the oregoing lication statements are true and correct. <br /> Print Name: <br /> Print Name: Signatu <br /> Date: 7�3 2-z 0(o <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> --Signature: Date: <br /> F:\DEVSVC1PIanning Application Forms\Revislons of Approved Actions doc Page 2 Of 2 <br /> (Revised 10-19-04) <br />