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I jrjA0111 <br /> I COMMUNITY DEVELOPMENT DEPARTMENT <br /> ADMINISTRATIVE / CONDITIONAL USE PERMIT <br /> FILE NUMBEi , k` , <br /> L tI bWF <br /> PRE -APPLICATION : ❑ <br /> Owner Information Applicant Information <br /> Fme : CAI l /� ' t � « � c �L Name : Q h � S Gt %res <br /> gdress : 4 � �� t^, V\ Lt.� ( ✓1 Mailing Address : 2 TE'/� t1 c h � e <br /> Phone : 2 G 'A %� O � - 4 11 Phone : C/ C <br /> Email : � S atm l oo Cot N � � Email : M c� e e � I � � (yCt � a0 <br /> Applicant's Representative Information , Design Professional Information <br /> Name : o %A& lr p 1> A Name : - <br /> �- <br /> Mailing Address : Mailing Address : C9 � G�1�0 C � � <br /> Stv cam- S� Z a <br /> Phone : ZO Ok 1 — (' S Cts I Phone : — Z� <br /> �oa . (m(� Email h <br /> Email : <br /> Project Description <br /> (Attach additional sheets as necessary) <br /> ❑ Administrative Use Permit <br /> Type of application ( check only one , separate applications or <br /> required for each ) : <br /> ❑ Conditional Use Permit <br /> Project Summary : <br /> a ✓ QCT C�• �' V�C l,1,2 a OL <br /> Will the project include more than one ( 1 ) phase ? (maximum of 2 phases) Yes : ❑ No : <br /> Length of time (maximum of 5 years) : K\ le- <br /> Note . <br /> eNote . For questions regarding phasing. contact the Planning Division at 209468-3121 <br /> Related Planning Application ( PA ) number( s ) : <br /> Is this application tied to another <br /> Yes : E] No : <br /> discretionary application ? <br /> Property Information <br /> Assessor Parcel Number Property Address Property Size Williamson Act Contract <br /> (� Q � - t1 7> 4 /v � t° �lC� � lY � AG Yes : E] No : ❑ <br /> Yes : ❑ No : ❑ <br /> Yes . ❑ No : ❑ <br /> Page 1 of 6 <br /> 03128 / 2023 <br />