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°U+" APPLICATION - QUARRY EXCAVATION <br /> L� ,ry <br /> N: :( <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: QX- <br /> •.,�qG/FOp <br /> AUTHORIZATION SIGNATURES <br /> OWNER; OPERATOR AND APPLICANT INFORMATION AND SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> Pro e o ner s or owners of surface rights list all owners <br /> Name: gate , Addressp, 0. Box 3191, MDdesto CA Phone(209) 521-9771 <br /> Signatur : , John Shoden, President 95353 1 Date: 6/20/05 <br /> Name: Address: Phone: <br /> Signature: Date: <br /> Name: Address: Phone: <br /> Signature: Date: <br /> Name: Address: Phone: <br /> Signature: Date: <br /> Name: Address: Phone: <br /> Signature: Date: <br /> Note: All Legal owners of the property(s) involved in this project or their legal agents must sign the application thereby <br /> verifying that the statements contained in the application are true and correct. If a legal agent signs the application on <br /> behalf of the property owner, written consent by the owner must accompany the application. <br /> cm <br /> „- Owners of mineral rightszf <br /> ;. <br /> Name: g ega c Addressp, O, Box 3191 Modesto CA Phon .209 521-9771 <br /> Name: Address: 95353 Phone: <br /> Operator <br /> NameM. y perces Address: p, 0. BDx 4760, Nbdesto CA Phone:(209) 524-3197 <br /> Name: Address: 95352 Phone: <br /> .':. Agent of process (person designated by operator as agent for the service process) <br /> Name: Jeff Welch Address: P. O. Box 3191, Nbdesto, CA Phone: (209) 521-9771 <br /> F 0EVSVCWIanning Application Forms\ Page 3 of 16 <br /> Quarry Excavation.doc.(Revised 643-04) <br />