Laserfiche WebLink
Com,SC4 16 <br /> APPLICATION - REVISIONS OF APPROVED ACTIONS <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> r;€, �ri„�_<TtIAE' B ?FiB'AP�pL�?[MLFRIgRJ't3FR,�[G:THEAFP P.7[ONL .,�:ua u•...a.%.< <br /> a•ss � tiit�4,z�'��:��'':�xa suY�y F � :iaks isa; 7 -' 4.w x> ,'s� x <br /> . r� ., :II' 1tCanf fntOtttWltOttL .:; <br /> Name: Fr Namr <br /> Address P.O. Box 575 Address:? _ <br /> Lodi CA. 95240 Stockton, CA. 95219 <br /> Phone: Phone: <br /> ;✓ :.x�t.yL� f ,M <br /> USE= <br /> aR`x"� 3 <br /> '." <br /> Revision to: _ _ Ma Condibon/s of Approval <br /> File No: <br /> t. Description of sed Revisions: rapjp , <br /> nr <br /> Error on application had 100 ' monopole on sife plan and 7n1rn .... <br /> on application. <br /> 2. State the facts showing the changes In circumstances which make the subject condltlon s no longer aro rlate or necessary. <br /> radio frequency propagation. <br /> AUTHORIZATION SIGNATURES' <br /> ONLY THE OWNERdF EHEPl20PERTYbRAN'/Et1THbRIZEDAGENTMAY FILE AN7APPUC:ATION—,I, the Owner/Agent agree,to defend, Indemnity, and hold harmless the County and its agents, oemployees from any claim, action or proceeding against the Owner/Agent's project <br /> I,further, certify under penalty of perjury that I am (check one): <br /> ❑ Legal property owner(owner includes partner, trustee, trustor, or corp <br /> property(s) involved in this application, or <br /> Legal agent(attach proof of the owner's consent to the application of the property's <br /> Involved in this application and have been authorized to file on their behalf., and that the <br /> foregoing application statements are true and correct <br /> ( <br /> Print Name: Phililp . Hawtin Signature: te: 8-1 -q7 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -2- <br />