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APPLICATION - APPEAL OF STAFF ACTION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Appellant Information <br /> Name: W v114 r1.i <br /> Address: y <br /> cc / <br /> Phone:204- q6i- 15"37 <br /> BASIS FOR APPEAL <br /> Be thorough In your statement,because only the findings and facts you raise In your appeal statement will be included in the <br /> stag's report to the Planning Commission. Attach additional sheets If necessary. <br /> Filenumbers - 7(c, Action being appealed: e C ow <br /> Date ofStaffaction: <br /> Stafe the basis of the appeal. List any findings of fact made by the staff which you feel were wrong and yourreasons: <br /> List any condition(s)and or findings being appealed and give reasons why you think It should be modified or removed: <br /> F�_ <br /> SIGNATURE <br /> Signature: Date: <br /> STAFF USE ONLY <br /> Remarks: Date appeal filed <br /> Fee: 1 LX, Receipt No: Appeal accepted by: <br /> z. <br />