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A�PpP{ L/2IICATIONg �CgSONTROL SHEET <br /> 3Y5[`�sf{vo d-91 <br /> o '1Ib1tl,U r�tlVl ,111 IfV bb-doll s <br /> rroApp Only: ❑Yes ,Ne .Foe: necalpt Number. Dole: <br /> °� <br /> rlie Number:. 5'��3�Lp Foo: /275 noeoi PINumbal {03Y2. Dale: 10—ZUG'` <br /> Filo Number: roe: necelpt Number. Dale: <br /> pilo Nwuben <br /> raa: necolpl Number: Data: <br /> 009cripitai,ofr I I C't4p t APP I al 4e1- a <br /> Address: S- ca R <br /> APN(e): 19 3_ 020—2 <br /> Ocn.1ni 19.11 Community: 54ocL.4c" Oena nl pion Dosigimllon: C <br /> ro ml Zonln Ovadny ZZ0110(3):7.aning Map: PP Y S� _ $ <br /> Adlnconl Oanwai rinn Zoning . <br /> North: ! .$4k.-Ia <br /> South: c Es <br /> Fact: C4 Cr C_G <br /> 1 <br /> Wect: <br /> log-Yam flood ❑ Yes ❑ No I Wlillom.ot,Act ❑ Vas ❑ No I Supervlsa,lal District: <br /> r <br /> Akpoet Nom specoic roof,l ❑ yes ❑ No: <br /> I11-tory: Lt 9 l ; DD 54 r7 <br /> All Applications <br /> Completed Appgeolion Forms P-- Owners'Slgnahav IY <br /> Copy of Dead as preliminary Title neporlD-� copies of Plan of Mop <br /> S%'x 11'noddcad Finn or Mop 9-1 1 toseldous Mnlerinls Disclosure Survey Lim <br /> Development Inlpecl Mtllgation roe ram O Assassar and History Pagos ❑� <br /> Nmnes 161' O, Sowa/Wolor'Will Sorva'Latter CI <br /> Donoml plan Mop• ❑ Zonbrg Mop' ❑ <br /> Solis nopurt• ❑ Solis Suitability Study' ❑ <br /> Subsidence Area 13 Yes 13 No Expensive Sell Area 13 Yes It No <br /> • 111coo Innierlals may not be raqulied for cadnln applications. Cbock Ilia npplicetion typo for details. <br /> Tadnllve Maps <br /> Mnp Sig„ed by Owr,ar ❑ Tfact Plumber and Name(Mnlor Subs only) ❑ <br /> Adlakdug P,oPedy Owners Names on Mop ❑ All Lots Numbered ❑ <br /> Contour Llnes ❑ Loenlian of Wall and Septic System ❑ <br /> Excnvnllons <br /> Doclmm�lion Pinn and Schedule ❑ Flnanelal Dumnnleo ❑ <br /> Typlcnl Clog'"cle-1 ❑ Elevation Cniculnllon Schedule ❑ <br />