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SU0004463
Environmental Health - Public
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EHD Program Facility Records by Street Name
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99 (STATE ROUTE 99)
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11492
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2600 - Land Use Program
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SA-01-04
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SU0004463
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Entry Properties
Last modified
11/19/2024 1:58:52 PM
Creation date
9/8/2019 12:51:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004463
PE
2632
FACILITY_NAME
SA-01-04
STREET_NUMBER
11492
Direction
N
STREET_NAME
STATE ROUTE 99
City
LODI
ENTERED_DATE
5/20/2004 12:00:00 AM
SITE_LOCATION
11492 N HWY 99
RECEIVED_DATE
1/22/2001 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\N\HWY 99\11492\SA-01-04\SU0004463\EH PERM.PDF
Tags
EHD - Public
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•✓ <br /> APPLICATION - SITE APPROVAL <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 <br /> employees from any claim, action or proceeding against the OwneNAgent's project. <br /> I, 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 property(s) <br /> ;application <br /> vo ved in thisapplication, or <br /> Legalagent(attach proof of the owner's consent to the application of the property's Involved In this <br /> and have been authorized to file on their behalf., and that the foregoing application statements are <br /> true and correct. <br /> Aspire Public Schools <br /> Print Name. _$y Charles Robitaille Signature: Date: 12/12/2001 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />
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