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SU0002162
Environmental Health - Public
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UP-01-09
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SU0002162
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Last modified
11/20/2019 5:11:33 PM
Creation date
9/4/2019 9:46:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0002162
PE
2626
FACILITY_NAME
UP-01-09
STREET_NUMBER
18325
Direction
S
STREET_NAME
AIRPORT
STREET_TYPE
WY
City
MANTECA
Zip
95336
ENTERED_DATE
10/23/2001 12:00:00 AM
SITE_LOCATION
18325 S AIRPORT WY
QC Status
Approved
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SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\A\AIRPORT\401\UP-01-09\SU0002162\EH PERM.PDF
Tags
EHD - Public
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INDEMNIFICATION AGREEMENT <br /> As part of this application, applicant and real property in interest, if different, agreed to defend, <br /> indemnify, hold harmless, and release the San Joaquin Local Agency Formation Commission, <br /> its agents, officers, attorneys, and employees from any claim, action, or proceeding brought <br /> against any of the above, the purpose of which is to attack, set aside, void, or annul the <br /> approval of this application or adoption of the environmental document which accompanies it. <br /> This indemnification obligation shall include, but not be limited to, damages, costs, expenses, <br /> attorney's fees, or expert witness fees that may be asserted by any person or entity, including <br /> the applicant, arising out of or in connection with the approval of this application, whether or not <br /> there is concurrent passive or active negligence on the part of the San Joaquin Local Agency <br /> Formation Commission, its agents, officers, attorneys, or employees. <br /> Executed at Manteca , California, on May 18 , 2005. <br /> APPLICANT REAL PARTY IN INTEREST <br /> r, (If different from Applicant) <br /> Signature: <br /> Signature: <br /> Title: Community Development Director <br /> Title: <br /> SUBMITTALS <br /> In order for this application to be processed, the following information needs to be provided: <br /> 1. One copy of this Justification of Proposal, completed and signed with original signatures; <br /> 2. Five prints of a full-scale proposal map showing the affected territory and its relationship to the <br /> affected jurisdiction (Refer to Guide for Preparation); <br /> 3. One copy of an 8.5"x 11"reduction of the proposal map; <br /> 4. One copy of a metes and bounds description of the affected territory; <br /> 5. One certified copy of the City Council and/or Special District Board Resolution of Application, or <br /> a petition making application to LAFCo(as appropriate); <br /> 6. Written permission from each affected property owner(or signature form); <br /> 7. One copy of the project environmental document; <br /> 8. One copy of the project Notice of Determination; <br /> 9. One 8.5"x 11"copy of the Vicinity Map(if not included on the proposal map); <br /> 10. One copy of the plan for providing services (refer to Government Code Section 56653); <br /> 11. One copy of the Pre-Zoning map or description (as required by Section 56375); <br /> 12. One copy of the Statement of Open Space Land Conversion (refer to Section 56377); <br /> 13. One copy of the Statement of Timely Availability of Water Supplies(refer to Section 56668(k)); <br /> 14. One copy of the Statement of Fair Share Housing Needs (if residential land uses are included <br /> in the proposal) (refer to Section 56668(1)); <br /> 15. One copy of the project design (site plan, development plan, or subdivision map); <br /> 16. One copy of the Residential Entitlement Matrix form (if residential land uses are included in the <br /> proposal); and <br /> 17. Filing and processing fees in accordance with the LAFCo Fee Schedule and the State Board of <br /> Equalization Fee Schedule. <br /> Additional information may be required during staff review of the proposal. <br /> CERTIFICATION <br /> The undersigned hereby certifies that all LAFCo filing requirements will be met and that the <br /> statements ma in thi ap lication are complete and accurate to the best of my knowledge. <br /> Date: ��/8 fQs <br /> (Signature) <br /> Print or Type Name: Benjamin J. Cantu Daytime Telephone: 209-239-8424 <br /> Justification of Proposal Revised:01-04-05 Page 3 of 3 <br /> B-3 <br />
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