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APPLICATION - REVISIONS OF APPROVED ACTIONS <br /> o T BONS <br /> SAN'JOAQUIN COUNTY COMMUNITY DEVELOP <br /> MENT......................................................::. <br /> TMENT <br /> ...................:::....::.:....4. ...r...;..: .1:!�.i•J.w.,: ::k' :?r•i�J}:r: .�}I.}:,!nJY.;lj,4!!::^:;:::::::::.�......?.............:.:. <br /> ) ...5,,::i%ii%•r:?i.'}f.::.: .,,!2.•:: ..:r <br /> v..n ♦ G�F➢.�i.%J/J6. }:h6,•'•':�(i:i•'•, 2iCf•%'i;ii'iii?i %:•.;•.;�?:? ?•j..i<ii% <br /> � A�f��.1�i��Ns•: .... <br /> i ti ,< <br /> ..>::is r �j; ':� ,•�.:. .::.:Y'<. ,�•. :./Ai%.G)k (;r(" Sv.: ). <br /> n••: r:r: r.}!•.{:i::• r•• ? :.. ... •$J .//. •f'•� � �•f,'ii'S.:}!ry`:!/ .�' >:: .)•�.ti. J�}•)f>Y•�<b: <br /> r�atrr <br /> Name: <br /> Y�� `. Address <br /> Address: 1��� <br /> l "� Phone: <br /> PhoneW. <br /> O(7/ <br /> y ............... <br /> :n': •}L:{:i'{<!SjK.,,'!; ?.C:.•.•�+at•�:':+:;::1+.:.r•}:S:::k�;�:::j :;::. <br /> :::�::t,}'r};}}'::....a., v:• vy :•' '•' ��`� �n\;.:>`\�:,a..}{;.�,. � .}:f,.., ..ki.M..:r,::::...kS•.:.: <br /> Ma Condltlonls of A (oval <br /> Revision to: <br /> File No: / ( 0 f <br /> f r d <br /> Dosed bon of Propos Revlslons:� <br /> -17 <br /> y State the(acts showln the than es dition s no longer appropriate or necessa <br /> In circumstances which make the sub ect con <br /> ere <br /> � Z i <br /> AUT.HORIZATIC7 SIGNATURES <br /> ONLY THE <br /> WNER OF THE.P P RTY'OR AN A'�JTHORIZED AGENT.MAY FILE AN ;APPLICATION. <br /> I,the Owner/Agent agree,to defend,Indemnify, d h againthe harmless tljAgent's project.unty and its e Co <br /> agents,officers and <br /> employees from any claim,action or proceeding <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 the <br /> property(s)Involved In this application,or <br /> Legal agent(attach proof of the owner's consent to the application of the property's <br /> p <br /> licatlon and have been authorized to file on their behalf., and that the <br /> Involved in this ap <br /> foregoing application statements are true and correct. <br /> t Signatu <br /> Print Name: . ��� t 1 <br /> . .....1 ._.. ...__ mate: ... <br /> Print Name: J Date: <br /> Signature: <br /> Print Name: Date: <br /> Signature: <br /> Print Name: Date: <br /> Signature: <br /> Print Name: <br /> -2- <br /> I <br />