Application for Z-1963-34 • r
P L A N y Io N uperti --na, a71 ornia
A P P L I C A T I C T'
( Please make an original and 3 copies)
File No
Applicant .�
Address:-
or
Property Description: Lot: ,L__ dock:�
'tract:
• y e'i X i��'�
Number of Acres: JL
Owner:
Proposal:
or Rezoning ) Annexation
..✓j Zoning �25 — Sign Permit Use Permit _ Tentative Subdivision
10
-`) Variance 1j Final Subdivision'
Arch. & Site Appr. —) misc.
Ruilding, Permit (_ ) Cther
(Chgs , per County)
U
Conditions ( "or Commission u3e only)
I certify that the foregoing statements are true and correct to the best Of
my knowledge and belief; and I agree to accept this re-zoninZ, Ordinarcenaed con-
permit or other, subject to the provislrns o: the Zoninr,
dit_ions specified above .
T)a t �
A'PPLI A T