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SU0016198
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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5646
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2600 - Land Use Program
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PA-2400083
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SU0016198
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Entry Properties
Last modified
11/19/2024 3:48:22 PM
Creation date
3/29/2024 4:29:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0016198
PE
2635
FACILITY_NAME
PA-2400083
STREET_NUMBER
5646
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95242-
APN
05516021, -45
ENTERED_DATE
3/29/2024 12:00:00 AM
SITE_LOCATION
5646 W HWY 12
RECEIVED_DATE
3/29/2024 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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-n:-� SAN:�JOAQ.UIN COMMUNITY ®EVELt�PMENT DEPARTMENT <br /> --- couN�r Y--- ADMINIS-fRATIVE/CO DITIONAL USE PERMIT <br /> �;.eafr,N.., <,,,w� ,,Nrt. ����8: OO 29 <br /> PRE-APPLICATION: � <br /> '�„p s;, „� ��"�� �;,�"�Ow r Information Apphca nt Information <br /> Name: E — Name: �{EIJi%�' �S<'cl� '��0� <br /> Mallin Atltlrass: ,aD _ D46 � /J �` �' Mailin Atltlress: � c,+�/�"�O / ry �/"��'� <br /> I y4. �S2 p STp�-a�N / SZ/ <br /> Phone: .'za7 Z —3 L(�3 Phone: ZL/>J Z— �8� <br /> Email GZ/E c T /� Com/ LC�� Email yjn . Scv1 /Z C' cf/��� C<T�� <br /> r��5':,, ;:, Apphca nt's Representative Information Y; ,may, DGsig n.Profes sioh allnformahon <br /> Name: Names: <br /> Mailing Atltlress: _ Mailing Atltlress: <br /> Phone' Phones: _ - - <br /> Email: Email: <br /> ' Prolcc[�¢ ri p[ion <br /> sc <br /> (AlIItch add,tlo, /s/ie¢[s as •cussary) <br /> Q Ad minlsiraLva Usa Permit <br /> Types of application(check only ones, separates applicationa or <br /> raquiratl for each): Gontlitional Use Permit <br /> Project Summary: '�///S bio OSS'-���� GC- S � �S �/5`/ G U .� � %L•s//'F �//'r t /� <br /> d er cn Z G �fruc-/mss' Z!o i/rr �7fiE i'�v i..x-/ o s r' <br /> dfsi - ,. !1Ccpsr Wi!/ �di�� a /o-w��/ /i/�� @l/y�G !/.va'6 / <br /> 2m a [v!l O e�<e L 7 0! t R /vl C/ 0 6 r �iP.7 �r 4ri/! <br /> Will the project include mora than ones(,)phase?(max/mum o/2 phases)Yas: Q No: <br /> Length of time(maximum o)5 years): <br /> No[v:FOr u¢a Nonv myvrd/O has/n p.c a P/ann(n dWalon al 20D-9B@-312f. <br /> Ralatetl Planning Appllcatlon(PA)numbar(s): <br /> la mla applir:ahon tlaa to anomer vaa:,0' No: p �ZO'V� ✓1-/pP4cq 7Tea--� <br /> tliscretiona ry application? <br /> Property lnformat,on <br /> As ssor Parcel Number Propc-rty Atldress PropertySize WilliamsonAM Contfael <br /> `i — �/O �- Z �l. A � Ld�7/ lin 7SZ�l ��'. 3SR G. Yes: D No:-�� <br /> OS'J-- (e!J - S— -�/!Q///.eLiJ 6 dL+�sf?I' 7i U G%C, Yes: (] No:$ <br /> Yas: (] No (] <br /> Pages t of 6 <br /> O]/28/R023 <br />
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