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;ZPCEIVED <br /> JUN 2 7 2017 APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> NVIRONMENTAL HEALTH ((�� ¢ q <br /> r PERMITISERV CES FILE NUMBER: SA- A 15 0 0 1 62 <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Owner Information Applicant Information �.-t}--��� '' <br /> Name: G Name: zr�l t tJ L� 'J <br /> Address: 2. Address: C' <br /> Phone: .4 7 57/10Phone: GJZ 6 <br /> PROJECT DESCRIPTION <br /> Proposal <br /> ��l1 <br /> Description of the proposed project: sr7u�l�.�r �.�•vrv� <br /> UJ <br /> �&5VI [-IE- 5!7- <br /> Business name(DBA): <br /> Employees/CustomerslDeliveries per Work Shift` <br /> '(attach additional breakdownlexptanation for each phase of development,seasonal production,etc. if applicable) <br /> NOTE. if the proposed development is an addition to an existing facilit , only list the additional Increases below <br /> Shift Hours Days of the week Number of Employees Customers per Shift Vehicles per Shift <br /> S <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) Number of Parcels Project Size Williamson Act C ract <br /> OBD , / Property Size ( ❑Yes 5No <br /> Property Address: <br /> Existing Land Uses <br /> On-Site Uses(include Ag Crops): Rl(-:�EV QD <br /> Uses to the North: /� <br /> Uses to the East: <br /> Uses to the South: <br /> Uses to the West: <br /> FADEVSVOPlanning Application Forms%Slte Approval.(Revised 02-03-10) Page 2 of 9 <br />