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SU0005780 SSCRPT
Environmental Health - Public
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SU0005780 SSCRPT
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Last modified
5/7/2020 11:31:46 AM
Creation date
9/8/2019 1:03:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0005780
PE
2622
FACILITY_NAME
PA-0500762
STREET_NUMBER
11573
Direction
E
STREET_NAME
NORMAN
STREET_TYPE
AVE
City
STOCKTON
Zip
95215
ENTERED_DATE
11/21/2005 12:00:00 AM
SITE_LOCATION
11573 E NORMAN AVE
RECEIVED_DATE
11/21/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\N\NORMAN\11573\PA-0500762\SU0005780\SSC RPT.PDF
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EHD - Public
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SEP-13-2005 09:27A FROM: T0:3694228 F':5 <br /> NOA JOB NUMBER: 1405106A <br /> PROPERTY I.00.A'I'TON: 11573 Norman Avenue, Stockton, Cati£ornia <br /> Page 5 <br /> NOA ENVIRONMENTAL <br /> ENVIRONMENTAL QUESTIONNAIRE AND DISCLOSURE STATEMENT <br /> PART 2: OWNER INFORMATION <br /> (To be completed by Owner or Owner's representative) <br /> 1. GENERAL INFORMATION <br /> 1. Current owner of property and contact information: year purchased: <br /> 2. Previous owner(s) and contact information (if available): years owned- <br /> 3. Please describe current use(s) of property: <br /> 4. Please describe any other known past use(s) of property, <br /> and approximate dates of each use- <br /> 7 <br /> 1 -C, X-, s <br /> 5. Are there any businesses using any portion of the property ❑Yes )i No <br /> which are operated by an entity other than the property <br /> owner (including a tenant farming operation)? <br /> If yes, please provide a contact name and phone number for <br /> each: <br /> 6. What is the current zoning and/or general plan designation of the subject property? <br /> Ifyou have any questions about this questionnaire,please contact Marney Rosulek at(209) 367-3701 ext 221 "0144 <br />
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