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COMMUNITY DEVELOPMENT DEPARTMENT <br /> SAN - lJ0AQUI NADMINISTRATIVE / COT L USE PE 'RMIT <br /> Com{ f. z4 C O U N T Y ---- <br /> _ I 1 13 U <br /> - `tfIFE <br /> 0 <br /> PRE -APPLICATION : ❑ <br /> Owner Information I F I bApplicant"Information <br /> Name : S � G Name : l� vlly &144J <br /> T6 <br /> Mailing Address D 4, /� � Mailing Address : <br /> Phone : v S — �p� !- Phone : 20 <br /> Email : Email : LeLlIl � ,? <br /> ;Applicant' s Representative Information Design Professional Information <br /> Name : 'S�/�t Ar rck/e Name : <br /> Mailing Address : Mailing Address : <br /> Phone : Phone : <br /> Email , Email : <br /> Project Description <br /> En <br /> (Attach additional sheets as necessary) <br /> �Coministrative Use Permit <br /> Type of application ( check only one , separate applications <br /> required for each ) : or <br /> ❑ Conditional Use Permit <br /> Project Summary [� YI�.S L U ` l�'- ke' K t 06, 6/ ? �'1� ,T eel1 S/ ST ofAL <br /> be <br /> Will the project include more than one ( 1 ) phase ? (maximum of 2 phases) Yes : No : ❑ <br /> Length of time (maximum of 5 years) : 4q /12647 7 CA <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 another Yes : No : ❑ PI'_I <br /> discretionary application ? <br /> �,Vc% ss/ 4rt7i0)�l <br /> Property Information <br /> Assessor Parcel Number G� Property Address Property Size Williamson Act Contract <br /> 0 - o © � S/- � w, ' GS'17A Z h' �rpo 05w aere t Yes : ❑ No : <br /> �Q Yes : ❑ No : ❑ <br /> Yes : ❑ No : ❑ <br /> Page 1 of 6 <br /> 03 /28 /2023 <br />