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SU0001177
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-01-19
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SU0001177
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Entry Properties
Last modified
5/7/2020 11:28:29 AM
Creation date
9/9/2019 10:45:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0001177
PE
2690
FACILITY_NAME
LA-01-19
STREET_NUMBER
19618
Direction
N
STREET_NAME
TULLY
STREET_TYPE
RD
City
LOCKEFORD
ENTERED_DATE
10/17/2001 12:00:00 AM
SITE_LOCATION
19618 N TULLY RD
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\TULLY\19618\LA-01-19\SU0001177\APPL.PDF \MIGRATIONS\T\TULLY\19618\LA-01-19\SU0001177\CDD OK.PDF \MIGRATIONS\T\TULLY\19618\LA-01-19\SU0001177\EH COND.PDF
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EHD - Public
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it ,� ,_, •�;,,,« <br /> LOT LINE ADJUSTMENT.' <br /> SAN JOAQUlN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> j <br /> ':'AUTNORr2AT1ON,SIGNATURES <br /> 1 ONLY T14E OWNER OF THE PROPERTY O A G <br /> � R AN AUTHORIZED AGENT htAYFILE AN APPLICATION. <br /> 5 <br /> 1, the OwnerlAgent agree,to defend,indemnify,and hold harmless the County and Its agents,officers and employees from any claim,action <br /> `II or proceeding against the Owner/Agent's project. <br /> 'i 1, further, certify under penalty of perjury that!am(check one): <br /> Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)involved In'thls <br /> I application,or <br /> O Legal agent(attach proof of the owners consent to the application of the property's Involved In this application and <br /> i have been authorized to Erle on their behalf.,and that the foregoing application statements are true and correct. <br /> if <br /> Print Name: offs rgnature: Date: <br /> Print Name: Signature: Date: <br /> �i Print Name: Signature: Date: <br /> of <br /> i Print Name: Signature: Date: <br /> EI <br /> Print Name: Signature: Date: <br /> i� <br /> �j <br /> 'j <br /> E� <br /> is <br /> E <br /> 1 Iji <br /> FI <br /> 1 iEi <br /> I <br /> 1 <br /> I <br /> is <br /> f <br /> f <br /> I <br /> fl. <br /> j <br /> I <br /> ' E i <br /> i <br /> i <br /> i <br /> Ise �---,._.�4�"W"" - _. -�• ...-�_ �-'�'�v.ua u—e..r.e..y�F`..-. -— - <br /> I � l <br /> Ei <br /> 1:l1 PMPA LABEFehnuary 1.1M <br /> `i <br /> :I <br /> E� <br />
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