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� UIN <br /> SAN <br /> __ <br /> APPLICATION - SITE APPROVAL LUIN COUNTY COMMUNITY DEVELOPMENT <br /> DEPARTMENT <br /> FILE NUMBER: <br /> SA- <br /> TO <br /> BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Owner Information <br /> Name: - Applicant <br /> Address: Information <br /> � <br /> /�! Name: _p I <br /> � � -� 'U Address: 77 <br /> Aj <br /> Phone: 25 <br /> �f Phone: `_C, 7 f' <br /> PROJECT DESCRIPTION <br /> Proposal <br /> Description of the proposed project: <br /> \_d a <br /> J � �- ( ✓S <br /> Business name(DBA): 2 (/ <br /> 76ty.ciC�sJ <br /> Employees/Customers per Work Shift <br /> Shift Hours Days of the week Employees(Number) Customerser Shift <br /> P Vehicle Trips per Shift <br /> Materials/Equipment Used <br /> Describe equipment used in the Project(include the number of automobiles and trucks): <br /> Describe materials produced,stored or used(all hazardous materials should be identified): <br /> t fA <br /> PROPERTY AND VICINITY DESCRIPTION <br /> Property Information <br /> Assessor Parcel Numbers) Property Size Number of Parcels Project Size <br /> •- O Williamson Act Contract <br /> yO 1 <br /> /D•/ Lk crc- <br /> Property Address: ( �;' ` ,L� , EJ [� No <br /> ', <br /> µl ) _ <br /> Existing Land Uses <br /> On-Site Uses(Include Ag Crops): <br /> Uses to the North: r tir <br /> � r <br /> Uses to the East: <br /> Uses to the South: <br /> Uses to the West: <br /> F.iDEVSVCtPlanning Application ForrnMsite Approval.(Revised 1-3-03 <br /> Page 2 of 9 <br />