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13 04 09- -qLa Sar, Court;•, 4633127 p. 2 <br /> .aQ�rN <br /> �- PA- 0300 3 2 <br /> A Ir t '� A T F k --— <br /> i i i pi I E Ti /L r�F��OVA F I <br /> EvhP11 :6: _ C0IY13lFjUNS'l DEVQ ARTMENT ' <br /> "FOR FILE NUMBER. SA- <br /> I' TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Owner Information <br /> Applicant Information <br /> Name: r <br /> blame: <br /> 11 Address: �€� �� o173 Address: <br /> 1759,Z 7 <br /> Phone: Z155e . Phone: N <br /> 1� <br /> I! PROJECT DESCRIP l lON `----� <br /> rr(5�65ai <br /> II Description of the proposed project: <br /> tf <br /> I —il <br /> Business name(DBA): <br /> Employees/Custom rg per NVork Shift <br /> Shift Hours Days of the week l Empbyees(Number) Customers per Shift Vehicle Tr r:ps f <br /> per Shift <br /> s F <br /> cafe,� j <br /> I <br /> MaterialslEquipment Used ` <br /> Describe equipment used in the project(include the number of automobiles and trucks): �- <br /> �a <br /> Describe materials produced,stored or used(all hazardous materials should be identified): ! �' <br /> - ll <br /> l <br /> a <br /> I <br /> PROPERTY AND VICINITY DESCRIPTION <br /> l <br /> Property information <br /> A Assessor Marcel Number(s) Property Size Number of Parcels Project Size Williamson Act Contract �I <br /> I, Yes �No <br /> li <br /> Properly Address: 0 Z ` h �- <br /> E=xisting Land Uses <br /> [! On-SiteUses(Include Ag Crops): <br /> _ l <br /> e pp <br /> U <br /> o <br /> tthe <br /> Uses to the East: �' ss� k :R+120,/-Sc <br /> t <br /> Uses to the South:Ir- cas r.a­ r <br /> Uses to the West; - ` <br /> "DEVSVC'Planhin9 Application Forms\Site Approval.(Revised 1-3-03; Page 2 of 9 <br />