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Revisions of Approved Actions Application Form <br /> SAN JOAQUIN COUNTY PLANNING DIVISION Part A <br /> 1810 EAST HAZELTON AVENUE <br /> STOCKTON, CALIFORNIA 95205 <br /> TELEPHONE: ( 209 ) 468-3120 <br /> (To Be Filled Out By Applicant ) <br /> Owner : ��,c���f�\ c�lli4( �pAPplicant:_ i `�. <br /> Address : 111' Address :_L�- - e <br /> City: Z, City: <br /> State/Zip: cc.l -� 1 �c �� .j State/Zip:! -- - <br /> Phone: `t,'��- y U Phone : <br /> iq $ <br /> Request is for a revision to:& Map Condition/s of Approval A <br /> involving an application for : <br /> File # P _ 79 o- \ Date Approved ,',-...e,,1,,J -9s, Vml 79' <br /> 1 . Description of Revisions : <br /> 9n--'7!3 ,....-0.- x'04 4-y ;'..}( i_ I <br /> 2 . State the facts showing the change in circumstances which make <br /> the subject condition( s ) of the map no longer appropriate or <br /> nec ssary. _ <br /> t ) , , . ^Icy <br /> C.l v JVD 42 <br /> 3 . Change initiated by:4Applicant Eng/Rep (fee required) <br /> County Dept. (Planning, Public Works , etc. ( no fee required ) <br /> Planning Commission (no fee required ) <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> Legal Property Owner (owner includes partner , trustee, trustor , <br /> or corporate officer ) , <br /> 1--.! Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and that the foregoing is tr e and correct . <br /> - �r-- - <br /> �\ (Signatu e ) (Date ) <br /> �J <br /> Revisions of Approved Actions - 5 - ( 2/87 ) <br />