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SU0003917
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-0300182
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SU0003917
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Entry Properties
Last modified
5/7/2020 11:30:19 AM
Creation date
9/9/2019 9:05:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003917
PE
2622
FACILITY_NAME
PA-0300182
STREET_NUMBER
2172
Direction
W
STREET_NAME
RIVER
STREET_TYPE
DR
City
STOCKTON
ENTERED_DATE
5/11/2004 12:00:00 AM
SITE_LOCATION
2172 W RIVER DR
RECEIVED_DATE
4/28/2003 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\R\RIVER\2172\PA-0300182\SU0003917\APPL.PDF \MIGRATIONS\R\RIVER\2172\PA-0300182\SU0003917\CDD OK.PDF \MIGRATIONS\R\RIVER\2172\PA-0300182\SU0003917\EH COND.PDF \MIGRATIONS\R\RIVER\2172\PA-0300182\SU0003917\SURV MEMO.PDF
Tags
EHD - Public
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--- -- _ APPLICATION-MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPM_E_NT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend,Indemnify,sproject. end hold harmless the County and its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project. <br /> I further certify, under penalty of perjury,that!am(check one): <br /> gal <br /> Pro <br /> O e alar opeory owner(owner Includes partner,trustee,grantor,or corporate officer)of the property(s)Involved/n this <br /> O Legal agent(attach proof of the owners consent to the application of!re property's i,,vu,''ved In this application and <br /> -------------- <br /> have been cutharked to nie on their behalf,and that the foregoing application statements are true and correct. <br /> Print Name: / — 4�0�� , <br /> Signature a. <br /> Print Name: <br /> � <br /> ,Print Nwmw; Signature: Date. <br /> Print Nwirye! PAW"q/ ., 0 <br /> signature! 7 <br /> PrinfNamal Pa fel �'O� <br /> a/aortaturef <br /> Date. <br /> N IN/NSUOAYM Joum NLV. Y 10.61 (IND) <br /> -5- <br />
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