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I COMMUNITY DEVELOPMENT DEPARTMENT <br /> WAIF F R <br /> COUNTY <br /> UN T Y <br /> _ . rA2400 <br /> 1 <br /> Grcctness rr6.. E4 � here , <br /> FILE NLIMBER : <br /> Owner Information Applicant Information l <br /> Name : accne. I kucf%ac cnu\ e Name : <br /> Mailin Address : <br /> Mailing Address : G �� " rs' g <br /> D`�,o� <br /> Phone : � 1� � okd Phone : n5 <br /> Email : ` ��,� � � Email : p � V <br /> Applicant ' s Representative Information Design Professional Information <br /> N <br /> Name : <br /> ame ; ) C� <br /> r ? ` <br /> Mailing Address : CO 11Q Mailing Address : <br /> CK C <br /> Phone : C� Q Phone : <br /> Email : ' V � � Email : <br /> Project Description <br /> (Attach additional sheets as necessary) <br /> Is this application being processed concurrent with another land use permit ? Yes No ❑ <br /> Application type . 1 Application numA 3 ber : 0Q <br /> Property Information <br /> Assessor Parcel Number Property Address Property Williamson Act Contract (Y or N ) <br /> Size <br /> Ef <br /> 1CG <br /> Page I of 5 <br /> 10 /3112023 <br />