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DESCRIPTION OF SITE <br />-~1 <br />Area (in either acres or square feet if less than 1 acre): rJ a- <br />Tax Assessor Parcel Number (TAPN): f7 (S ~- 135 ~ (7~ ~` ~ ~ ~ S ~ ~~/~' 015 'U17~, ~5~(3~U(5~~' <br />~ r <br />Existing Zoning: - 3 <br />Existing Land U <br />Proposed Land 1 <br />Water Service (Public or Private, if public list District): W //~' <br />Sewer Service (Public or Private, if public list District): ~~" <br />I hereby certify that 1 am making this application as owner of the above described property, or acting <br />under the authority of the owner (attached authorization, if not owner). I am familiar with all pertinent <br />requirements, procedures, and fees of the County. I understand that the Application Review Fee is <br />non-refundable. All statements made on this form and additional application materials are true to the <br />best of my knowledge and belief. <br />Name ~n Sn~ fb1 - y/ laP /~lps,r~,~f Date: 6' 'G6 <br />(Owner's Printed Name) <br />Name: /'<2~l~ ~/ ~~ "~2/ ~di Si9ii J~h <br />(Own is Signature) <br />