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SU0003475
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-0300630
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SU0003475
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Entry Properties
Last modified
5/7/2020 11:29:56 AM
Creation date
9/9/2019 10:34:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003475
PE
2690
FACILITY_NAME
PA-0300630
STREET_NUMBER
22550
Direction
N
STREET_NAME
THIRD
STREET_TYPE
ST
City
CLEMENTS
ENTERED_DATE
4/30/2004 12:00:00 AM
SITE_LOCATION
22550 N THIRD ST
RECEIVED_DATE
12/9/2003 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\THIRD\22550\PA-0300630\SU0003475\APPL.PDF \MIGRATIONS\T\THIRD\22550\PA-0300630\SU0003475\CDD OK.PDF \MIGRATIONS\T\THIRD\22550\PA-0300630\SU0003475\EH COND.PDF
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EHD - Public
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LOT LINE ADJUSTMENT <br /> SA JOA U N COUNTY <br /> :)MMUNITY DEuELOPMENT bEPARTMENT i <br /> WO AGENT AfA <br /> F ANAP ! <br /> 1, the Owner/Agent agree,fo defend,indemnify,and hold harmless the County and its agents, officers and employees from an claim ac <br /> Proceeding against the Owner/Agent's project. <br /> Y , tion or <br /> 1, further, cert! under Penalty of perjury that l am(check one): <br /> �' P Y P d ry <br /> erty owner(owner includes partner, trustee,grantor, or corporate officer)of the property(s)involved in <br /> fX14hL-1es9aaP'proCpat1on,or <br /> 0 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 applicat' statements are true and correct. <br /> Print Name: <br /> Signature: Date: <br /> Print Name: -G GJ Print Name: Signature: <br /> Date: <br /> � <br /> Signature: Date: <br /> Print Name: Signature; <br /> Date: <br /> Print Name: <br /> Signature: Date: <br /> i; <br /> 1 <br /> { <br /> E <br /> i� <br /> i <br /> I <br /> I <br /> I <br /> i? I <br /> rl <br /> k, <br /> i <br /> I <br /> f <br /> it <br /> , of <br /> i <br /> ,f <br /> F,DEV7LA/1pAp%/PWINAPPS/LOTLINFAWAPPMAK AN 7/1/99 <br /> fI ff <br /> ------------ <br /> 'I I <br />
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