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SU0014666
EnvironmentalHealth
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2600 - Land Use Program
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GP-99-3
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SU0014666
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Entry Properties
Last modified
12/16/2022 4:24:12 PM
Creation date
6/16/2022 3:15:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0014666
PE
2600
FACILITY_NAME
GP-99-3
STREET_NUMBER
23122
Direction
S
STREET_NAME
KASSON
STREET_TYPE
RD
City
TRACY
APN
23906005
ENTERED_DATE
12/21/2021 12:00:00 AM
SITE_LOCATION
23122 S KASSON RD
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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APPLICATION - ZONE RECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1,the Owner/Agent agree,to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> 1,further, certify under penalty of perjury that 1 am(check one): <br /> O Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> O Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name:/19 i/q/P �EL/yiS Signature: �1 � �1 �. Date:/AZA <br /> Print Name: Signature: (/ Date: <br /> Print Name: Signature: Dato: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> t <br /> r <br /> -5- <br />
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