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SU0002578
Environmental Health - Public
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EHD Program Facility Records by Street Name
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VALLEJO
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11290
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2600 - Land Use Program
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SA-00-40
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SU0002578
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Entry Properties
Last modified
5/18/2022 5:08:33 PM
Creation date
5/13/2022 2:28:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0002578
PE
2633
FACILITY_NAME
SA-00-40
STREET_NUMBER
11290
Direction
S
STREET_NAME
VALLEJO
STREET_TYPE
CT
City
FRENCH CAMP
ENTERED_DATE
10/29/2001 12:00:00 AM
SITE_LOCATION
11290 S VALLEJO CT
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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APPLICATION - SITE APPROVAL <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 /> 1, 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 property(s) <br /> involved in this application, or <br /> 2 Legal agent(attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name: &E, A . Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />
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