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SU0004667
EnvironmentalHealth
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26 (STATE ROUTE 26)
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18754
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2600 - Land Use Program
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PA-0400588
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SU0004667
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Entry Properties
Last modified
11/20/2024 8:50:26 AM
Creation date
9/9/2019 10:28:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004667
PE
2632
FACILITY_NAME
PA-0400588
STREET_NUMBER
18754
Direction
E
STREET_NAME
STATE ROUTE 26
City
LINDEN
APN
10517048, 47 &
ENTERED_DATE
10/21/2004 12:00:00 AM
SITE_LOCATION
18754 E HWY 26
RECEIVED_DATE
10/18/2004 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 26\18754\PA-0400588\SU0004667\APPL.PDF
标签
EHD - Public
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APPLICATION - SITE APPROVAL <br /> 7r <br /> AUTHORIZATION SIGNATURES. <br /> ONLY THE.OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPL1CATlt?N <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 Owner/Agent's project. <br /> 1, 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 property(s) <br /> involved in this application, or <br /> Legal agent(attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been en authorized to file on their behalf., and that the forego'ng application statements <br /> are true and correct. <br /> Print Name: z, N Sign slur "r Date: <br /> Print Name: ✓ l aturet Date: <br /> Print Name: Signatu : Date: <br /> Print Name: Signature: Date; <br /> Print Name. Signature: Date: <br /> I <br /> i <br />
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