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°a �. .�. PLAN APPLICATION/AMENDMENT <br /> < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT �D��EPARTpMENT <br /> �q FILE NUMBER: lJ 2 � kJ <br /> /FOR <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> PLAN: General Plan <br /> (Check only one) <br /> (Separate application needed for each document.) ❑ Master Plan for <br /> ❑Public Financing Plan for <br /> ❑Specific Plan No. (if any)_for <br /> ❑Special Purpose Plan for <br /> ❑ Other <br /> TYPE OF AMENDMENT: MAP ❑ TEXT ❑ BOTH <br /> ❑ COMMUNITY <br /> ❑ OTHER LOCATION <br /> ❑ NOTA MAP CHANGE <br /> OTHER APPLICATIONS BEING SUBMITTED CONCURRENTLY <br /> r2. <br /> Application Number(to be completed by staff) <br /> IKFCZA5S1FICA7101 l 2. <br /> 3. 3. <br /> APPLICANT �7 n A OWNER <br /> S <br /> Name: I'1R 7 �T j2kAu WHf Name: Mm. <br /> Address: 62.1 CjOSPORAT'E k JAV Address: 621 COR PCP 41—F WAX <br /> X <br /> City: M16111ON ' State:l Zip: Qy539 City: AOMI&Vr Stattee:C4 Zip: 3 y <br /> Telephone#: 857-75�& Telephone#: ?_0q— <br /> F:\DEVSVC\Planning Application Foms\ Page 2 of 7 <br /> Plan Application Amendment.doc.(Revised 05-11-09 <br />