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SU0012933
Environmental Health - Public
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MS-87-21
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SU0012933
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Last modified
2/3/2020 9:35:53 AM
Creation date
2/3/2020 9:12:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012933
PE
2622
FACILITY_NAME
MS-87-21
STREET_NUMBER
445
Direction
N
STREET_NAME
WINDSOR
STREET_TYPE
AVE
City
STOCKTON
Zip
95205-
APN
14341011
ENTERED_DATE
1/16/2020 12:00:00 AM
SITE_LOCATION
445 N WINDSOR AVE
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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t <br /> " Environmental Information <br /> For Staff Use Only <br /> File No. <br /> Date Filed <br /> APPLICATION FORM PART B: <br /> ENVIRONMENTAL INFORMATION <br /> (To be Filled Out By Applicant ) <br /> NOTE: In completing this form, use additional sheets if necessary. <br /> Answer all questions to the best of your ability. If question . <br /> is not applicable to your project, write NA (not applicable ) . <br /> Please do not leave blanks . Incomplete forms cannot be accepted. <br /> I <br /> PERSON COMPLETING FORM PROPERTY OWNER X AGENT OF OWNER <br /> Name . `N01JG- EW&WEERS. INC. <br /> Address -L10 N "VNT"ER- ST- <br /> City STDG <br /> State Zip CA IS-Lo-t-- <br /> Phone 4-{o4-4-L3Z- <br /> TYPE OF APPLICATION MI Nab- SUBDIVISION <br /> PROJECT 34-ZLI A- Sa. FT- i'WCEU IN 10 <br /> THR-tE LOTS PARCEL A nND B 103137. a. Fl". <br /> AN 0 PAP-cE l_ C IS 4 S(Q S9. FT <br /> I <br /> OTHER PERMITS AND APPROVALS (COUNTYg REGIONAL, STATE AND FEDERAL) <br /> REQUIRED FOR THIS PROJECT <br /> PERMIT AGENCY <br /> NONE <br /> -1- (9/85 ) <br /> Plan-44 (12/85) <br />
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