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SU0001239
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-00-59
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SU0001239
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Entry Properties
Last modified
11/19/2024 3:48:09 PM
Creation date
9/9/2019 10:24:12 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0001239
PE
2690
FACILITY_NAME
LA-00-59
STREET_NUMBER
20899
Direction
E
STREET_NAME
STATE ROUTE 12
City
CLEMENTS
Zip
95240
ENTERED_DATE
10/18/2001 12:00:00 AM
SITE_LOCATION
20899 E HWY 12
RECEIVED_DATE
7/24/2000 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\20899\LA-00-59\SU0001239\EH TRACK LOG.PDF
Tags
EHD - Public
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LOT LINE ADJUSTMENT <br /> E, SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> i <br /> AUTHORIZATION SIGNATUREs <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1,the OwnerlAgent agree, to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim,action <br /> or proceeding against the Owner/Agents project. <br /> 1,further, certify under penalty of perjury that 1 am(check one): <br /> X <br /> Legal property owner(owner includes partner,trustee,trustor, or corporate officer)of the property(s)involved in this <br /> :application,or <br /> I <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 rile on their behalf.,and that the foregoing application statements are true and correct. <br /> t <br /> Print Name: ,A k1- j Signature: Date: <br /> Print Name: A5a bvARD C. CR41 C Signature: to: do <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> 3 <br /> f <br /> a , <br /> `1 <br /> i <br /> s. I <br /> 1:41 PMPA LA90 February 1,1999 <br /> _4 <br />
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