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APPLICATION - REVISIONS OF APPROVED ACTIONS <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> a>.:... :............... <br /> .;r. . rW.- <br /> MOM' ...::.:.. <br /> ............ ...•,••. >..t •. .:.. .. ..f.'f{yh//,..\'avx.:/f.-.'•.<'y / <br /> ........... ..........:::..:.'thy t.t. <br /> ::.:::::. <-:....:fin . T ;x•:.;;;:;r;z; K;:; <br /> i:;:::;:^:;i:;.vt::;ii�;*;�;-r� 5=0: :... .. '.' ...• .'. �r.:f.�:I�}•.�I�n .-f �.....••:"-.�'.-•-'•-...'-'-�YrI1�•�:}•;•;F.}`Y,.ryy}:k.:h nvirfrn:r^:v'>:i:�:?+!t�:<�>:"'::: <br /> n...::T:ar.:: ....... 1 ... .. .. 3:�•.>:bi t.... >.......i.....::: <br /> ............. •.:gin:...........• v rf'..v.... Q`.�'f.....v.ry rY '�SMrs.3s`•/.•�t°°'l/f•-........... ..... r;.:9}h n4:... �...:::.::.:•±�:^�:::i:'.:. <br /> ,: ::>:�::±:.:.±::>• :::'C�a#FI •.:;...:..:.:...::...:.:.:.:.�±:-:.i..:;..�:. .....::.,.f,>..:?�.; : .;•.;:A Fcat�attfotrt�a#PcKT:.: ..;±i±-.:;;:;:•1..::.. . ..:±;>: <br /> Name: l� Yom ' J L C{�l/Lt,t ,�,// Name: <br /> Address: 3 L Ul tCI L(J� V`��1 Address: <br /> S <br /> Phone: Cj — Lk u (p S (0 Phone: <br /> ........... .::::;i:::?: <br /> Ni}nw::.�:::... - .:N.,.:ify(i:,:..%%'i v't;t.ASW}:•;}};}y...1.. ....... ai:C:!. <br /> }::i:::i:!U:"?:4 i:., f...�:±.S.:.C..n..::..-: n...tS'.rri.(n: •'..:. <br /> :. ......n..........:::t•;:J;±:�}i.:•;.I r................. .. .....n..:>Y;:y:t;±i}x.A .. .. <br /> .nvt.n,... <br /> ..._ ...... ... . . _. <br /> Revision to: / Ma �j —�� — 0 Conditions of Approval <br /> File No: <br /> 1. Description of proposed Revisions: <br /> I - <br /> I ,T h1 �G1 — S P �G� l C� L C tkv 4 i G1 <br /> 2. State the facts showing the changes in circumstances which make the subject condition(s)no longer appropriate or necessary. <br /> M e v:�s �• s �� ea S c <br /> y If <br /> 5 �nr� 1 Lam, wart Pi <br /> � - <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE-PROPERTY OR AN'AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend, indemnify,and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the Owner/Agent's project <br /> I, further, certify under penalty of perjury that I am (check one): <br /> Legal property owner(owner includes partner,trustee, trustor, or corporate officer)of the <br /> property(s) involved in this application, or <br /> Legal agent(attach proof of the owner's consent to the application of the property's <br /> involved in this application and have been authorized to file on their behalf., and that the <br /> I <br /> foregoing application statements are true and correct. <br /> I <br /> Print Name: C� C� CG((%�� Signature: Date: ' <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> i Print Name: Signature: Date: <br />