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SU0003463
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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PA-0300549
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SU0003463
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Entry Properties
Last modified
5/7/2020 11:29:55 AM
Creation date
9/6/2019 11:06:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003463
PE
2690
FACILITY_NAME
PA-0300549
STREET_NUMBER
9404
Direction
E
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
ENTERED_DATE
4/30/2004 12:00:00 AM
SITE_LOCATION
9404 E LOUISE AVE
RECEIVED_DATE
10/21/2003 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\L\LOUISE\9404\PA-0300549\SU0003463\APPL.PDF \MIGRATIONS\L\LOUISE\9404\PA-0300549\SU0003463\CDD OK.PDF \MIGRATIONS\L\LOUISE\9404\PA-0300549\SU0003463\EH COND.PDF \MIGRATIONS\L\LOUISE\9404\PA-0300549\SU0003463\EH PERM.PDF
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EHD - Public
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a � <br /> LOT LINE ADJUSTMENT <br /> SAN JOA UIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> O&YTHEOWNER OF THE PROMa On AN AUTHOnIZED 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,action or <br /> proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that 1 am(check one): <br /> Legal property owner(owner Includes partner, trustee,grantor, 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 and <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> r <br /> Print Name: !&)' C � I1199440Signatur <br /> Date` <br /> Print Name: Signature: Date: <br /> Wnf Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> Print Name: Signature: Data: i <br /> FTDLVsEA/IDARK/PLWAPP9/LOTLI NEAGIAPP roM REV 7/1/99 -4- <br />
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