Laserfiche WebLink
..au n. Map Amendment Application Form <br /> a 'Fay <br /> 2, y� <br /> �• Part A <br /> SAN JOAQUIN COUNTY PLANNING DIVISION <br /> 1810 EAST HAZELTON AVENUE <br /> STOCKTON, CALIFORNIA 95205 <br /> TELEPHONE: (209 ) 944-3722 <br /> (To Be Filled Out By Applicant) <br /> Owner: ,I)fnnc �Gn ��o. Applicant: 4V - 4-z'z.-4-- <br /> Address: Po Address : ?Z3 - &u J% fT <br /> City: Guoi City: e <br /> State/Zip: R 2 -/.s-1 7 State/Zip: C" ,,f 9,-24 0 <br /> Phone .4 74 -GPB.r Phone: �7 6-1 Y -G/91L _ <br /> Permit Information (Minor Subdivision or Major Subdivision Application <br /> previously approved ) <br /> Permit Number: U Approved By : P• C <br /> Date Approved: //-,?o <br /> Request <br /> 1. Indicate what condition( s ) are proposed to be modified: <br /> 2 . State the facts showing the change in circumstances which make <br /> the subject condition( s ) of the map no longer appropriate or <br /> necessary. <br /> / c SG c in n ��✓fG ''� <br /> O 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 /> LJOwner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> a at the foregoing is true and correct . <br /> 3-31 -87 <br /> (Signature ) b (Date) <br /> (7/86 ) <br /> Map Amendment <br /> ��- 5 - <br />