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SU0003558
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-0200367
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SU0003558
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Entry Properties
Last modified
5/7/2020 11:30:02 AM
Creation date
9/9/2019 10:59:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003558
PE
2690
FACILITY_NAME
PA-0200367
STREET_NUMBER
16113
Direction
S
STREET_NAME
VICTORY
STREET_TYPE
RD
City
OAKDALE
ENTERED_DATE
5/7/2004 12:00:00 AM
SITE_LOCATION
16113 S VICTORY RD
RECEIVED_DATE
8/20/2002 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\V\VICTORY\16113\PA-0200367\SU0003558\APPL.PDF \MIGRATIONS\V\VICTORY\16113\PA-0200367\SU0003558\CDD OK.PDF \MIGRATIONS\V\VICTORY\16113\PA-0200367\SU0003558\EH COND.PDF
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EHD - Public
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j LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ? i AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AG1;NT MAYFILE AN APPLICATlpN. <br /> 11 the Owner/Agent 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/Ilgent's project. <br /> 1, further, certify under penalty of perjury that I am(check one): <br /> I <br /> Legal property owner(owner includes involved i partner, trustee, trustor, or corporate officer) of the property(s)invol <br /> application, or n this <br /> F O Legala9 nt(attach proof of the owner's consent to the application Of the property's Involved In <br /> have been authorized to file on their behalf.,and that the foregoing application statements are trueland coapplrrect. <br /> and <br /> E <br /> F Print Name: <br /> Signature: � <br /> 4 Print Name: � II / '.- ,� Date:. <br /> I •! Sig nature: <br /> f Print Name: �•I IT l Y Date: f � <br /> o <br /> Signature: ;e <br /> Date: <br /> Print Name: <br /> Signature:« Date: <br /> Print Name: II _ <br /> it Signature: <br /> II Da te: <br /> I <br /> II <br /> �i <br /> I <br /> i <br /> I <br /> li I <br /> i <br /> li <br /> i <br /> ;I <br /> ! <br /> �I <br /> II ,� <br /> 1:41 PMPA_LA96 February 1,1999 i <br /> II -4 <br /> j <br /> jl <br />
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