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SA 40AQUIN COMMUNITY DEVELOPMENT DEPARTMENT <br /> SITE APPROVALIUSE PERMIT <br /> P2 ® © 058 <br /> � <br /> FILE NU : <br /> PRE-APPLICATION: ❑ <br /> Owner Information Applicant Information . <br /> Name:Abdo Mohammad&Amria Alsumairi Name.-Abdo Mohamad <br /> Mailing Address: Mailing Address: <br /> 2702 Patterson Rd, Riverbank, CA 95367 2702 Patterson Rd, Riverbank, CA 95367 <br /> Phone:209-534-0827 Phone:209-534-0827 <br /> Emaitaisumeri1459@gmail.com Email:alsueril459@gmail.com <br /> Applicant's Representative Information Design Professional Information <br /> Name:Elizabeth T. Erhardt-Attomey Name:Advanced Engineering Service <br /> Mailing Address: Mailing Address: <br /> 100 Pine St. Suite 1250, San Francisco, CA 94111 10774 Savoy Cir, Stockton, CA 95209 <br /> Phone:415-710-9060 Phone:209-952-7926 <br /> Email:Liz@erhrdtLit.com Email.advancedengineedng@comcast.net <br /> Project Description <br /> (Affach additional sheets as necessary) <br /> ❑k Site Approval <br /> Type of application(check only one,separate applications <br /> required for each): or <br /> ❑ Use Permit <br /> Project Summary: <br /> Use property as convenience store-grocery items and out food from deli with off site liquor sales <br /> Will the project include more than one(1)phase?(maximum of 2 phases)Yes❑ No X <br /> Length of time(maximum of 5 years): five months or less <br /> Note:For questions regarding phasing, contact the Planning Division at 209-468-3121. <br /> Related Planning Application (PA)number(s)- <br /> Is this application tied to anotherBP-2101226 <br /> discretionary application? Yes ■❑ No❑ The Roof Has Been Completed <br /> Tied to Map Amendment <br /> Property Information <br /> Assessor Parcel Number Property Address Property Williamson Act Contract(Y or N) <br /> Size <br /> 123-191-06 1804-1808 Country Club Blvd, Stockton,CA 95204 5116 Sq ft N <br /> Page 1 of 6 <br /> 031,3012021 <br />