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A <br /> 4 O <br /> NOV 1vQ3 <br /> fNViRONiv�t <br /> :,.T <br /> 14 <br /> p�MIT 1 SLRV iC;tS <br /> APPLICATION CONTROL SHEET <br /> To.bo completed by btivelnpmont Snrvlco coil <br /> Filo Number: S —� 3 Feo: 3�0 ~ { nocaiot Numbar: r �j �t Oale: 7T <br /> Description of Project S'�r h U,g , __�t. /�i.+o +r 'L'• lz <br /> wa <br /> Pro oct Locnilon• 41 / q <br /> Addreas: "Z2 `L 3 <br /> APN(s): I > 15- 1 - 1 <br /> Genornl f Inn Community: <br /> Pion Designnllon: L+ <br /> Zoning Mnp: Property Zoning: �I� �— Ovoriny Zono(s): <br /> too•Ynnr Flood ❑ Yes ❑ No Willinm:on Act ❑ yes !3 rfo 1 Suparvlsorinl Dlslticl: <br /> Alrpotl Alen: Specille Pinn(s) ❑ Yes ❑ No: <br /> I Ilsiory: <br /> All Applications <br /> Compinted Application Forms Owners'Signature <br /> Copy of Deed or Prollminnry Title ncport ' Copies of Plan or Map <br /> t3'/i x I I' Floducod Pinn or Mnp Q I fazardous Materials Disclosure Survey ❑ <br /> Development Impact Mitigation Fee Form Q Assessor and History Pages ❑ <br /> Nnmos Us( ' ❑ SowegWatar"VIII Servo'Letter ' ❑ <br /> Goncrol Plnn Mnp • ❑ Zoning Map • ❑ <br /> Solis noport • ❑ Solis Suitability Study• ❑ <br /> Subsidence Arca ❑ Yes Q No Expansive Soil Area ❑ Yes ❑ No <br /> • Those malerinis may not be required for certain applications. Chock the application type for details. <br /> Complolod By: <br /> Date: <br /> — +— <br /> epperur.rrn <br />