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bubmttai Number 93-0174 Date Received 01/22/93 ,Site Code: 1765 Site !Name: BEACON CARDLOCK STATION #27 Address: 3300 WATERLOO RD City: STOCKTON Zip: 95205 Lead Agency: Contact: ,I, Phone: 209/582-0241 �lling Name: Hill Info OK? Address: City: State: Zip: Contact: Phone e�r+nnar•�u El�.�n Qu lfinn.+yi�r..:. Name: Phonic: Address: City: State: Zip: Client Information (if different from Owner/Operator) i_ Name: Phone: Address: City: State: Zip: ib Applicant's name, date signed, title Name: Date: Title: x Consultant Company: Contact Name: p Phone: Other Contact name or Info: Phone: ;i it Program Element: 3528 Pilling Code: I! Assigned To: MM n Title of Submittal: LETTER OF COMMITMENT . I Date of Submittal: 01/20/93 iI OT Request: N OT Request Date: Action Date Action Date Type of Submittal: 18 Letter Req Add. Info Regstd SrP`Due Permit Fee Paid 0.00 Revision ed _R Due Comments Check No./Cash Report�(RZkw% mp -2(-� ` Par"Due s j Date paid )FRP:,Due Add. Info Recvd Denied Permit Fee Paid 0.00 Special Permit Issued: Check No./Cash Wrkpin Revw Comp Comment Ltr Sent Date Paid Staff Review. Due: OT Scheduled: I OT Completed: Action Date Action Date Action Date k/Com Ltr Ek/Com Req Add. Info Regstd SrP`Due Ltr �RWQCP Heed Revision ed _R Due Comments Report�(RZkw% mp -2(-� ` Par"Due Othr Agency Appr File/la Ace �--� )FRP:,Due Add. Info Recvd Denied Revision Due IPermit Type: Special Permit Issued: Oth'�Agency Due Wrkpin Revw Comp Comment Ltr Sent Project Complt