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SU0000413
Environmental Health - Public
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EHD Program Facility Records by Street Name
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FORREST LAKE
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3440
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2600 - Land Use Program
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MS-90-60
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SU0000413
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Last modified
2/27/2020 4:29:41 PM
Creation date
2/27/2020 4:26:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0000413
PE
2622
FACILITY_NAME
MS-90-60
STREET_NUMBER
3440
STREET_NAME
FORREST LAKE
ENTERED_DATE
9/19/2001 12:00:00 AM
SITE_LOCATION
3440 FORREST LAKE
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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❑ SIGNATURE ---— - ——- -- --- --- - --- — <br /> I certify under penalty of perjury that I am (check one ) : <br /> Legal Property Owner (owner includes partner , trustee, trustor , <br /> or corporate officer ) , <br /> L--� Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> anf th t the foregoing is true and correct . <br /> i.,l i�-4ff <br /> (Signature ) (Date ) <br /> Minor Subdivision - 6 - ( 6/86 ) <br /> y <br />
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