Laserfiche WebLink
1 -Gtr' -1 9C:;5 2 -5 7F1 1 F= RU1.1 AGE NC; 2 "2 9`)i i U / k11 � � ' ` �° • 7 <br />SAN TOAQUIN CUIJN'.l'Y <br />PUBLIC ILEA . iM SERVICES <br />F.N'v,Tlto NMF,NTAL Hr-, A.LI-H DIVISION <br />PUI33LIC RECX)RDS RELEASE APPLICAII-ION <br />APPUCAl•4'L' Y e ✓r YI hl G.� t b YI PHONE NO <br />A DDRFSS _ <br />/1.f:F1rIt'X T1AhtP 1� unuC cj_ %fie_ i ►I vr�ntn rs3+H PIIONE N()__-__-- <br />/1.DDRESS 1 gD3 <br />)FILB-AI4If t!:$ <br />-7X057 1414I 0,51 enr;tr <br />1 70 1 <br />Tq m 0' 156,41 -vu <br />7 <br />N- <br />u1 i7o�a a 5. <br />7A6_t._---- <br />iwN:t._L? A_QRtgC ! <br />DA'I1i <br />THIS I41JTICE IS SURIECi TO THE REQUIREMENTS IDEN"II 1ED IN Trill PL?£LIC IiEni.Tli <br />SI:RVTCF.SiFt4VIRONN.SFNT/+1,HEAL.TlI DIVISION (EIID) POLICY #92-007, ORDIIIANCE CODE OF SAN <br />1(mQum C OUN-1Y, EIID FEES AND. SEPWIC& CIfARGE RESOLUTIONS. STATE `:/ATTIR CODE, <br />GOV imliNIEN'T CODE AND THE EVIDENCL CODE. <br />A P•1A; IhIL)hI OP TEN (10) EPRFI;i.ISE ADDRF.SSrS PER REQUEST. <br />2PUBLIC I -ILL- ,'ItECOPS)s RE4 IEW ARE 17Y �,PPUrr�T1.:EN ONLY. nPFr?rrrt.sFrlTs ARI <br />AMUsIGED BY CAI..LING (209)468-0340. OFF -ICE HOURS FOR APPOINTMENTS ARE SCR DULED <br />1.10 DAY TIIRU FRIDAY LXCLUDING 1101JI)A 'S, 8:00 A-EEi. TO 12:00 MOON AND 1:01) P.M. TO 4:310 <br />P.M. <br />t. A PUBLIC: RECORDS RELEASE APP LICAllON AND A NON-REFUNDABLE DEPOSIT of 578.00 <br />IS REQULRCD. DI -POSITS. WILL 13E RETURNED TO Tiic .-kPPL1C.UgT IF THF IFILL"-S,P.ECORDS ARE <br />P'O'1',1V;I,II..'IALE V;jTjI1N THE (--USTODY OF THE ERD. <br />4. 11I17 ABOVE IDF_NTiFll D DEPOSIT 1.1; APPLIED TOWARDS T13I: TOTAL. I-ii_6 RL=V]I;NV FEE <br />CHARGE. 'ME. BAU%NC13 OF TIS CHARGES ARE DUE AND PAYABLE PRIOR TO ITWIEWING THE <br />D C7CU MEN.I (S). <br />S. PUBLIC 1FILES/P.ECORAS NOT RETURNED IN T142 SAME CONDITION AS RECFIVELti WiIJ. BE <br />CORRECTED BY THE MID STAFF AT THE =ENSE OF THE APPLICANT. 'THIS ADDITIONAL <br />SFRVICE RILL Bir AILL E-13 TO THE A;'FLICAI T FOR PAYMENT. <br />f. ORIGINAL. PUBLIC FiL'F_lQlRCCORDS SHALL NOT RE REMOVED FROM T1IE EIID i'R.EMJSu- . <br />SIGNATUR.F OF APPLICANT <br />SIGNAIIJU F OF R F:I_FASING OFFICIAL, <br />Lit UC) 14 (ICGV 12/9z) <br />AVL DATE S '7~a 7 <br />DATE <br />