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APPLICATION COP-ROL SHEET <br /> ixca s S. <br /> Y xs.. � °ria«.,mP. gY; s3 's� <br /> Prr.App:❑Ycs!No res Receipt Numbs D■tc <br /> Mile Numb=s . y r� l S 9 0% Receipt Numbs: (Z fs 2 y Date <br /> FBe Numbs Fes Receipt Numb= Date: <br /> FUe Ntmrbe: Fee Rcccpt Numb= Date <br /> Project Dc=nptlom S rT APP(La✓AL A PPC icA r-)041 Fo/Z 7 2 V-C�kPA M e t 411, <br /> T 7 rT OF r - 4-tea r40P <br /> PmJ—Location: L e A y—-0 4 i e 6 119 f TrIz C,r= <br /> u A D f t/ -r,4 <br /> Address I J (n t r. T, /L d N si Y L A M JL P <br /> APN(s) 2 yj - //j - L) y ZZ- <br /> Enterprise Zone ❑Yes■No General Plan Designation: ( /- U/7. <br /> I <br /> Property Zoning: Zoning Map: LI-9'�7'2-lJ P General Plan Community L,A TH/Z.D f <br /> North: <br /> South: `Y //L C/ / -t✓ C-!Z <br /> East: _v 4 07- U—LO <br /> West: 114 /— rJ <br /> 100-Year Flood❑Yes■No Zone - t,/ Williamson Act❑Yes■No Prime Soil MYes❑No❑NA <br /> Airport Am❑Yea talo Specific Plans)❑Yea■No Supervisorial jJ <br /> Name Road Name: District: <br /> Histol- ! ^9 3'10 ~ <br /> e. <br /> : <br /> Completed Applications Forms ■ Owner or Agent Signature ❑ <br /> Copy of Decd or Preliminary Title Report' ■ Hazardous Materia Ls Disclosure ■ <br /> 8 IR'a 11'Reduced Plan or Map • Copies of Plan or Map ■ <br /> Soils Suitability Study' ❑ Assessor and History Pages ■ <br /> General Plan Map*/Zoning Map* a Soils Report' ❑ <br /> Subsidence Area❑Yes III Expansive Soil ❑Yea■No <br /> ��+..,,».�„�„:: as ,..•v x + ,,.:: x ¢T.t^:a�Tw s�„r..,a u�'����" s� ��' <br /> •1TiESE h ATERJAf S MAY NOT BE REQUIRED FOR CERTAIN APPLICATTONS <br /> CHECK TPfi ABPLTC.-%1ION:TYPE FOR DETAILS < <br /> Map Signed By Owner ❑ Tact Number and Name(Major Subdivisions 6ey)C <br /> Adjoining Property O.mrx Names on Map ❑ All Lots Numbered ❑ <br /> Contour lines ❑ Location Well R Septic ❑ <br /> e xv apL �Y TI •1EXCeSVATIONS ,,.F,.�>*"A`"¢c e. �NOV. a as`a*c.• <br /> Reclamatlon Plan and Schedule ❑ Financial Guarantee ❑ <br /> Typical Cross-Sections ❑ Elevation Calculations ❑ <br /> Engineer's Stamp ❑ M.R.Z.❑Yes❑No <br /> Completed By: G Date <br /> Uontrot.xa <br />