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SU0003604
Environmental Health - Public
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2600 - Land Use Program
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PA-0200321
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SU0003604
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Entry Properties
Last modified
10/22/2020 8:28:49 PM
Creation date
9/4/2019 6:32:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003604
PE
2690
FACILITY_NAME
PA-0200321
STREET_NUMBER
3050
Direction
E
STREET_NAME
FIG
STREET_TYPE
AVE
City
MANTECA
ENTERED_DATE
5/7/2004 12:00:00 AM
SITE_LOCATION
3050 E FIG AVE
RECEIVED_DATE
7/31/2002 12:00:00 AM
QC Status
Approved
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SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\F\FIG\5050\PA-02-321\SU0003604\APPL.PDF
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EHD - Public
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JT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY ORANAUT40RIZMAGENT MAY FILE AN APPLICATION. <br /> 1 <br /> 1,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and its agents,officers and employees from ally claim,action or <br /> proceeding against the Owner/Agent's pioject. <br /> 1,further, certify under penally of perjury that i am(check one): <br /> Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)involved In this <br /> application,or <br /> . 0 Legal agent(attach proof of th9 owner's consent to the application of the property's involved In flits application and have <br /> been authorized to file on their behalf.,and that the foregoing application statements are true and correct <br /> I <br /> Print Name. Cx'Kk\ R LZSignature: . Date; <br /> Print Name: p 5 I- Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date; <br /> K1RKVEWsfiyOO OEN REV.Vif" <br />
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