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APPLICATION QUARRY EXCAVATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> .ca.V.Z. FILE NUMBER: QX- <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Owner Information Applicant Information <br /> Name: K -Name: <br /> Address: i > Address: <br /> Phone: <br /> -3 Z-0 2— 4 1 e� - ��- <br /> Phone: <br /> PROPERTY AND VICINITY DESCRIPTION <br /> Property Information <br /> Assessor Parcel Number(s) Property Size Number of Parcels Project Size Williamson Act Contract <br /> 13 (ACJ 3 C Rj Yes El N <br /> I Property Address: <br /> Employees/Customers/Deliveries per Work Shift* <br /> *(attach additional breakdown/explanation for each phase of development,seasonal production,etc. if applicable) <br /> NOTE: if the proposed development is an addition to an existing facility, o ly list the additional increases below <br /> Shift Hours Days of the week Number of Employees Customers per Shift Deliveries/Other per Shift <br /> Materials/Equipment Used <br /> Describe equipment used in the project(include the number of automobiles,trucks,forklifts, etc.): <br /> Describe materials produced,stored or used (all hazardous materials should be included): <br /> ILL 5AAD <br /> 7. <br /> Existing Land Uses <br /> On-Site Uses (include Ag Crops): <br /> Uses to the North: <br /> Uses to the East: <br /> Uses to the South: <br /> Uses to the West: <br /> F:\DEVSMPlanning Application Forms\ Page 2 of 19 <br /> Quarry Excavation.doc.(Revised 02-03-10) <br />