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D <br /> PLAN APPLICATION/AMENDMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> pA-1 <br /> FILE NUMBER: <br /> TO BE COMPLETED-BY THE APPLICAN <br /> T PRIOR TO FILING THE APPLICATION <br /> PLAN: 21 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: V MAP ❑ TEXT ❑ BOTH <br /> [3 OFCOMMUNITY NntAe <br /> ❑ OTHER LOCATION <br /> ❑ NOTA MAP CHANGE <br /> OTHER APPLICATIONS BEING SUBMITTED CONCURRENTLY <br /> Type Application Number(to be completed by staff) <br /> 1. 1. <br /> 2. 2. <br /> JF,,e <br /> 3. 3. <br /> APPLICANT OWNER <br /> Name: <br /> Name: 6_94,asAL CA,29t a p, 1A3(,, <br /> Address:- 1 l 7 !ST i Address: �) �Cf 14 'AJ Y 420 <br /> City: F'I IWFCA State: (A zip:_ ,.T?,3(o City,l°l lk-r,,,,q-'K_'F State: _Cj�!_Zip:1533t, <br /> Telephone#: (00fi) Telephone#: ZOGI) Z'a <br /> FIDEVSVC\Planning Application Fonns\ Page 2 of 7 <br /> Plan Application Annendnnent.doc.(Revised 05-11-09 <br />