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�Yr OG - <br /> APPLICATION - REVISIONS OF APPROVED ACTIONS <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> + FILE NUMBER: - <br /> aL,l <br /> TO'8E;COMPLETED:BY THE APPLICANT PRIOR TO'FILING THE APPLICATION <br /> Owner Information: Applti;ant:irtToimatlon <br /> Name: Mark:Rose i :Name: G-ranite'Construction Company <br /> Adc ressa -Address: .P'.0.Box 4528T <br /> Sacrarnento,CA 95851 <br /> Phone: <br /> ti f 441 Phone; (916)855-4473 y <br /> PROJECT DESCR1p'I tON i <br /> Proposal . <br /> Revision to: Map Gondtton(s)of Afsproii8l <br /> File NO:PA-02-377 <br /> 1, De$criptiombf the proposod Revision's: <br /> Per Condition I m of thele,Conditions of°Apprrjval,'we are required,toO j y reclaim the site by pecemtier 31 2bl 1 We would like to <br /> requesfan extension to[december 31,-2012.. <br /> 2. State the facts showing the changes in'circumstances which make4he-subject'condit1on(s)no tonger appropriate ornecessary. <br /> Granite:Canstruction Company-has completed,redamation and filed a site.closure application with San Joaquin County for the <br /> property covered.under this use permit.. The site closure,process with the County and Office of Mine Reclamation could take tip to <br /> sfx Ynon(hs. <br /> AUTHORIZATIOWSIGNATU.RES. <br /> ONLY THE OWNER OFIRE PRO.Pek7Y ORAN AUTHG,RIZEtr ,, ELT,'MAY; IL ,AN APPLICATION, <br /> I, the Owni rdA nt a ree;.to defend; mdem.ni <br /> 9 fy5 anti .h Id,harmless the County.and,Its;,agents,,Qfficea S"and,e1np1oyee5 <br /> from ariy elaim. action or proceeoing against the Gbtantyarising from#'he:QvrnerlAgent's pfgject,. <br /> 1, further,certify under penaitymof perjury that:[am (check one)' <br /> Legal property oriner(av►rner Ecrcludes partner,•trustee; grantor,°or'corporate'offcerj:of the property(s) invatved J0. <br /> this application, <br /> [] Legal agept':(attach proof`of the owner's consent to the application ofthe p.roperty's',involved in this-apptication and <br /> have been authorised to.file on their behalf: and that the,,foregoing application s temen s afe,true and correct. <br /> r wr4.... Rr signature: , . . 0 �a <br /> Print[Name Y °i l �_ -,!a e <br /> 4 <br /> Pnnt Name: Signature. Date: <br /> Print,Name: filQY k Signature: 7�� <br /> pate: ID as <br /> P.rint,Name Signature:` Cla'te: <br /> P,rint;Name: Si naturd: <br /> F:%DEVSVCW44innmg:Apprication:F6ft"sXZevisions of Apo.rovW Actimr doo P age 2 of,,2; <br /> (RevfsetE'65-1 t oi3j <br />