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SU0001305
Environmental Health - Public
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2600 - Land Use Program
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LA-00-07
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SU0001305
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Entry Properties
Last modified
5/7/2020 11:28:37 AM
Creation date
9/4/2019 6:39:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0001305
PE
2690
FACILITY_NAME
LA-00-07
STREET_NUMBER
22889
Direction
S
STREET_NAME
FREDERICK
STREET_TYPE
AVE
City
RIPON
ENTERED_DATE
10/18/2001 12:00:00 AM
SITE_LOCATION
22889 S FREDERICK AVE
RECEIVED_DATE
2/7/2000 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\F\FREDERICK\22889\LA-00-07\SU0001305\APPL.PDF \MIGRATIONS\F\FREDERICK\22889\LA-00-07\SU0001305\CDD OK.PDF \MIGRATIONS\F\FREDERICK\22889\LA-00-07\SU0001305\EH COND.PDF \MIGRATIONS\F\FREDERICK\22889\LA-00-07\SU0001305\EH PERM.PDF
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EHD - Public
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LOT LINE ADJUSTMENT <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,actlon <br /> or proceeding against the Owner/Agent's project <br /> !,further, certify under penalty of perfuryIthat 1 am(check one): <br /> Legal property owner(owner Includes partner,trustee,trustor,or corporate offlcer)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 /> i <br /> t; <br /> Print Name: Signature: Z7 <br /> Date. O/�� <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i, <br /> ei <br /> t .. <br /> 4., <br /> j r <br /> ` 1:41 PMPA_Uk f Februory 1,1M <br /> —4— <br /> ifi i <br /> n <br />
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