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DEVELOPMENT APPLICATI& 12 2012 <br />TRACY C17Y OF MACY CITY USE <br />1% DevelOPment and Engineering Services <br />IV 333 Civic Center Fqaza <br />Tbb Tracy, California 95376 <br />Phone: (20 9) 831-6400. MON <br />OWNERS) <br />* (IF DIFFERENT THAN ABOVE) ADDRESS <br />e a161 wo FAX NUMBER <br />reil <br />TREET ADDRESS AND LOCATION (BE SPECIFIC) <br />73 <br />.T <br />I "76-/Y,772A&Y fiLvD, <br />-StZSGRS PARCEL NUMBER(S) <br />KISIING USE 9!PROPERTY <br />TA /-J <br />KfJVIUE A BRIEF DESCRIPTION OF P <br />.4f)01'T(&41 't,6 7V 41-A) <br />'//z <br />MV6 6" <br />rg WZ17 <br />The CkYwants this review process to be successful for You. On the back of this form, please descrta specific requests or suggestions to help <br />us meet Your needs as we work together on your project. <br />PROPERTY OWNER STATEMENT: <br />I hereby authorize <br />n7_1 and any authorized representative thereof, to act as made <br />in all matters related to the <br />subject applIcallo is) and recognize that the City of Tracy will rely In 9 od faith upon assurance and commitments made by the above referenced agent <br />In the course of reviewing requests for entitle s bmitted on my if. <br />PROPERTY OWNER(S) SIGNATURE: 1. <br />3. <br />APPLICANT STATEMENT: ue X.?,/ 51 -Per /iior" <br />I the hereby certify that to the best of rrry knowledge the foregoing application contains info on s <br />lure t <br />actlil i I i: !1!:'i and truthful I Iful a I I J that mHyi'iiUi'e t �'supplly such Information as requested may jeopardize, I - Ildity of an rmall which I <br />the Inability of the City to complete review as requested herein. D"? plilliftent granted or may result in <br />A C l E <br />W <br />