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Itoms 1.4 to be completed by aP licant:
I. APPLICANT NAt.E AND ADDRESS:
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I Cq.- �� % 5 7'6
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2+ PROJECT DESCRIPTION.''
3, ASSESSOR'S PARCEL NUMDCR(S): 6 '57 Z.
a,. PROPOSED USE: 57r-,
'The °Follow Ing items are to be completed by the Planning Department:
CURReN' ZONING,
LAND CONSERVATION ACREhigNT:
GENERAL PLAN DESIGNATION: i'A /LG
bavel'-opm6nt Site Desi nation_Criteria: YES
140
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It is recommended that you perforin
th'a following chockad. items: .
3
ARCEL.%MLO,GICAL RECORDS CRECit
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-�-
BOTANICAL SURVEY
5,
.------
GEOLOGICAL SURVEY
6 .
1.
YES.. NO
8'
WITHIN DEPARTTtENT OF FISH
g
AND GAft DEVELopjVNT ZONE: ><
10
10,
11 -
WITHIN FLOOD PLAIN! '
Staff Determination: Subs'Antially, conforms td:
WnHylt Awl, SPEC,zFIC OR
LAND USE PLAN:
GENERAL PLAN: 1. bend Use
If Yes.,f�/%� /�Fyd•
2, Conserv atibn
Name of Plan
3. Open Space
4 safety �('
WITHIN ulzE3AN RESERVE:
5 Noise^
:
If Yes,
6. Housing
Name of Reserve
7. Circulation
ZONING;
AIRPORT i.A11D USE PLAN:(
CU,�iNt1rNT' ,
,. � :
;. aifi �o.lata�r�nonaCotlltlfi�
i
QraVi 0� �,
Staff 5iHnaturc-►.,-��-.:...�.�:;."
ro
Date
AS TEt1; APPLICANT FOR THE REQUESTED LANK DIVISION, I Aft AWAFUr OF TELE; ABOVE S AF IN ' EGARbING
THECONFt7RMANCr< IJITiI THE. GENERAL PLAN AND ZONING,. ►�
�.,. HARD(,
_. g
ba" ted,_Si nature of1_Apphnnt�Y� �-..
;<Ttjis report will oxpire and be d3scardad 'sill (6) tnontl £rorr the ate of. ;he'r:taff
sign iiture.
LD 1000B trevised 6-87)