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SU0015842
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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PA-2300150
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SU0015842
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Entry Properties
Last modified
6/26/2024 8:02:20 AM
Creation date
9/21/2023 10:15:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0015842
PE
2611
FACILITY_NAME
PA-2300150
STREET_NUMBER
19300
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
MOUNTAIN HOUSE
Zip
95391-
APN
20906068
ENTERED_DATE
9/21/2023 12:00:00 AM
SITE_LOCATION
19300 W GRANT LINE RD
RECEIVED_DATE
9/20/2023 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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uuwuiyi �i I V c up. 1u . uu r I "V <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> SIGNATURE: <br /> I certify under penalty of perjury that lam (check one): <br /> Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> Legal agent (attach proof of the owner's consent to the application of the property 's involved in this <br /> application and have been authorized to file on their behalf <br /> and that the foregoing application statements are true and correct. <br /> DocuSipned by: <br /> 5 / 31/2023 <br /> Signat Date: <br /> Signal, Ye 68WE83768NFE... Date: 5 / 31/2023 <br /> 5131/2023 <br /> Signatu FA 6 e°n ...y Date: <br /> Signatu zi A4AF... Date: 5 / 31/ 2023 <br /> c ne <br /> Signatu e: 66 ' ° 7 aEe... Date: 5 / 31/2023 <br /> F:Mounlain Ho eFMF8W Wm/MH-Plan Tide Amnd Form-MASTER <br /> _g_ <br />
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