Laserfiche WebLink
g i <br /> _ FU i�lVY1Gk '1'r_lb .7c. <br /> SW. JOAQUIN COUNTY <br /> runjO HFAL#gmvlcEs <br /> E]VMONMMTAL HILTS DIVISION <br /> rMUC RECORDS SASE APPLICATION <br /> AI3P�.CCANT GQ � p ONE No <br /> AGENCY NAM _!' , � v Su .� FIIONS NQ 5�✓tc <br /> .ADDRESS s <br /> i <br /> I�T�$}W.DRSSS �.C�AN� DATE <br /> 215• 3S.3o S S <br /> vr�Nv <br /> 3.S' a-4 (V""�. <br /> —r- <br /> M <br /> Al. C&rkrSf n <br /> TITls manris sUBJRCC T'[] g REQUIRE IUMIS u)vTn WD IN TIIB PUBLIC. HEALTH <br /> ' IMZV[CLRNEN VIRt,'YMBNPAL AFALTH UEVMON(END)POLICY M-007,ORMANCE CODE OF SAN <br /> x)AQL" CMNTY, iBID FM AND 5MVICE CHARGE Ri"sSt?LtMONS. S:IATS RATER CODE. <br /> 00VERNMENI'CODE AND THIS l3VIDENCE CODE. <br /> 1. A RAMMUM o P TEN (IO)FREMXSE ADDRE.9SES rM RIRQM-r. <br /> i <br /> 2. Pt3BLIC 19La►RECOltD3 REVIRN ARE RYA aMg M I?MT ONLY. APMIN LENTS ARR <br /> ARRANGM BY CALLING (2Q9)458-OW, 0M(6 UO PZ FOR AIR 9CMR ULED <br /> MONDAY THRV FMAY DCCLUI)INO 11MIDAY9.8.119 A.M.TO 12.W NOOK AND I"PAL TO 4:30 <br /> P-hL <br /> F 3. A PUBLIC RECORDS RUXASE APPUCATioN,AND A XO� DSPQQT OF 578.0 <br /> is MUIRHD. DEY'Osm WiLL Bis RB'1'umm Tp THE AMUCAN1'IF=FIILESIRECORDS ARE <br /> NOT AVAILABLE W MRN'I CUSFOi)Y OI,IMI3 EIID. <br /> 4. THE ABCVB JDWT IPM DE110W IN APMED TOWARDS TM TOTAL FILE"VIEW I'E8 <br />€ alA R13EL TAH BALANCE E Of',IM C2IAIWM ARB DUE AND PAYAEILEgRIt7�TSD REvTRw I o TILE <br /> i DOCUMBN M. <br /> e E <br /> S- PURI.IC FILBS4MCORDS NOT RI3'IURNED IN THE SAME?CONDIT10N AS RE;CEiVM WILL I?a <br /> CCRRE� ll"10 FJID STAFF AT THE MEP'E 4M (77"g AMlCAXr- MW ADDMONAL <br /> SFBtVTC -WILL BE BR.L= TO UM APPLICANT PC*PAYMENT. <br /> E� 8. C RICiNAL P[IM UC FRIWJRECDADS SEfALL NOT BE REMOVM VROM <br /> THE ERD PRSi6IISE3- <br /> SIONATURB OF APJPUCANT i �! DATE° -ZLJ <br /> I� SIOiu,�TtJX?OP R LXA-' N- 6MC:IAL BATH <br />! F11 Ora 14(REV 12f42) r <br /> f . <br /> TO-FL P.022 <br />