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SU0001213
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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LA-01-14
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SU0001213
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Entry Properties
Last modified
11/12/2019 11:59:16 AM
Creation date
9/6/2019 10:59:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0001213
PE
2690
FACILITY_NAME
LA-01-14
STREET_NUMBER
12781
Direction
E
STREET_NAME
LOCKE
STREET_TYPE
RD
City
LOCKEFORD
ENTERED_DATE
10/17/2001 12:00:00 AM
SITE_LOCATION
12781 E LOCKE RD
RECEIVED_DATE
3/12/2001 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\L\LOCKE\12781\LA-01-14\SU0001213\SURV MEMO.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 THF 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 fr <br /> Of proceeding against the owner/Agents project. <br /> om any claim,action <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> O Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the propert s Involved application,or Y(1 in this <br /> fl 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 free and correct. <br /> Print Name: !tet i-t,i L < G e. 4 c id <br /> Signature: <br /> Print Name; �E�IL'�� - Date: Z—Ir—p/ <br /> Signatures: y <br /> Print Name: Date: � <br /> ` Signature: 01,117 <br /> Print Name: Date; <br /> Signature: - <br /> Print Name: Date: <br /> Signature: <br /> Date: <br /> i <br /> i <br /> i <br /> i <br /> 1:41 PMPkLARS Febvary 1,1988 <br /> -4- I <br />
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