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APPLICATION - QUARRY EXCAVATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 4. <br /> APPLICATION FORM <br /> cownNUF-[a O <br /> 4.a� ... 5 <br /> s3 <br /> OWNER,OPERATOR AND Ap}tiOCANT INPORMATION ANO$IGINATt)RCi <br /> ONLY THA`OWNr-R OF T119 PMOPeP1TY On AN AUTNORIZFW A43ENT MAY FltX AM APPLtCl114tf: <br /> _u. <br /> Nrc .• 4 (e1 of owner*a1 t+U1'faa4 rI�hIM,(llst eti„tawn+�rtM' a4_ .; ,.. �x; <br /> rd Rurlib l e A*6*1e: P. b. Sox-2 51 - <br /> slonsture: Salida, CA 95368 per: <br /> Name Address: Phone: <br /> ®lynstureOats. <br /> MEN <br /> Nom: Address: Phon*: <br /> 8lpnetur*: Date: <br /> Name: Address: Phots: <br /> Nignatws: Oats: <br /> Name: Address: Phone; <br /> "nature: Oats: <br /> HoWg AN LogN 6WnWe of the property(*)Involved In this project or their legal agents must sign the eppKaatbn~*by <br /> vsrWOM Wud the etatemente contained In the application are true and correct. if a legal agent signs the epplleation an behalf <br /> of the properly owner,written consent by the owner must accompany the application. <br /> ftwvrarral at mNNiiry ttot+at x Nz <br /> Name: Addreses p, 0 r1ox 3 19 1 Phone- - <br /> Name: Addrese: 95353 phone: <br /> <.. ,'. �R <br /> Name: Address: p, O. Sox 3191 Modesto C Phono: 5 21-9 7 6 <br /> Pho <br /> Name Addrase: M' <br /> IfplaeM a![ dwu OwAu otod by aper+ »*ttaiawtpair i1r + 1.1w 1 <br /> T �s 9P,,.t+t.:3:i <br /> 31 Name Catrol *Pref Address: p, O. Box 3191 Modesto Cd Phone 521-977 <br /> a -3- <br />