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D'0. IK. APPLICATION - SITE APPROVAL <br /> :� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �g7coR P. FILE NUMBER: SA- fM 15 0 0200 <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Owner Information Applicant Information <br /> Name: Name: <br /> N /1 <br /> Address: r Address: /KS L.. <br /> o c r <br /> Phone: - _ 2 Phone: 20, <br /> PROJECT DESCRIPTION <br /> Proposal <br /> Description of the proposed project: <br /> e <br /> Business name(DBA): �T IC <br /> Emplo es/CustomerslDelivbries per Work Shift' <br /> `(attach additional breakdown/explanation for each phase of development, seasonal production, etc. if applicable) <br /> NOTE: if the proposed development is an addition to an existing facility,only list the additional increases below <br /> Shift Hours Days of the week Number of Employees Customers per Shift Vehicles per Shift <br /> � 7 <br /> Materials/Equipment Used <br /> Describe equipment used in the project(include the number of automobiles,trucks,forklifts, etc.): <br /> Describe materials produced,stored or used(all hazardous materials should be included): <br /> PROPERTY AND VICINITY DESCRIPTION <br /> Property Information <br /> Assessor Parcel Number(s) Property Size Number of Parcels Project Size Williamson Act Contract <br /> !Xi es ❑ No <br /> Property Address: ZDG3 .. G. -2 <br /> Existing Land Uses <br /> On-Site Uses(Include Ag Crops): <br /> Uses to the North: / ]y <br /> Uses to the East: <br /> An &12-- <br /> Uses to the South: 41W 00-OA <br /> Uses to the West: - <br /> F:\DEVSVC\Planning Application FormsZte Approval.(Revised 02-03-10) Page 3 of 10 <br />