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SU0004310
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-0200279
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SU0004310
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Entry Properties
Last modified
5/7/2020 11:30:38 AM
Creation date
9/9/2019 10:21:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004310
PE
2632
FACILITY_NAME
PA-0200279
STREET_NUMBER
1001
Direction
N
STREET_NAME
STOKES
STREET_TYPE
AVE
City
STOCKTON
ENTERED_DATE
5/17/2004 12:00:00 AM
SITE_LOCATION
1001 N STOKES AVE
RECEIVED_DATE
6/27/2002 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\S\STOKES\1001\PA-0200279\SU0004310\APPL.PDF \MIGRATIONS\S\STOKES\1001\PA-0200279\SU0004310\CDD OK.PDF \MIGRATIONS\S\STOKES\1001\PA-0200279\SU0004310\EH COND.PDF
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EHD - Public
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APPLICATION - SITE APPROVAL <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, and hold harmless the County and Its agents, officers and <br /> employees from any claim, action or proceeding against the OwneNAgent's project. <br /> 1, further, certify under penalty of perjury that I am (check one): <br /> I <br /> L7 Legal property owner(owner lnclgdes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved In this application, or i <br /> O Legal agent(attach proof of the owner's consent to the application of the property's Involved In this, <br /> application and have been authorized to No on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name: �un Signature: - <br /> Date: <br /> Print Name: �hpSignature: L <br /> PrintName: Date: <br /> Signature: Date: <br /> Print Name: Signature: <br /> Data; <br /> Print Name: Signature: <br /> Dato; <br />
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