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SU0000062
Environmental Health - Public
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EHD Program Facility Records by Street Name
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JACK TONE
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12076
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2600 - Land Use Program
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MS-99-27
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SU0000062
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Entry Properties
Last modified
4/8/2022 5:15:49 PM
Creation date
9/6/2019 10:22:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0000062
PE
2622
FACILITY_NAME
MS-99-27
STREET_NUMBER
12076
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
STOCKTON
Zip
95215
ENTERED_DATE
8/8/2001 12:00:00 AM
SITE_LOCATION
12076 N JACK TONE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\J\JACK TONE\12076\MS-99-27\SU0000062\EH COND.PDF
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EHD - Public
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APPLICATION - MINOR SUBDIVISION <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 /> I,the Owner/Agent agree,to defend,Indemnity,and hold harmless the County and Its agents,officers and employees from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> I,further, certify under penalty of perjury that I am(check one): <br /> I$ Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)involved in <br /> this application,or <br /> O Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application <br /> and have been authorized to file on their behalf.,and that the foregoing application statements are true and <br /> correct. <br /> Print Name: Reggie Katzakian Signature: Date: S j <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -5- <br /> MA <br />
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