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• SPECIAL USE APPLICATION CHECKLIST THE FOLLOWING ITEMS MUST BE SUBMITTED ALONG WITH THE APPLICATION: Please include this checklist wish your application / 2. Proof of ownership by deed (1 copy) 5.11~~~/ 1. A letter of request (10 copies) that contains: / Date of application i Owner and representative (address and phone number) / Site location and present zoning / Request and reason for the special use permit ~ Existing and proposed facilities, structures, roads, etc. .~ Signature of owner or representative' 'Letter of consent authorizing representative to act in owner's behalf must be included 3~ Proof of water by one of the followi~n"g":~(2 copie ~~%~ Letter from Water District - u'r~~/l4GUCt a~'l Copy of vrell permit i Applicant's statement that cistern is used with information on where water is t obtained/purchased. A letter from water supplier shall be submitted. 4. Proof of sewer by one of the following (2 copies) Letter from Sanitation District Cih~-County Health De,Partment preliminary investigation form ~ other SF~T~lT C ~4oll~~Bl~Ti~k7s~ / 5. Plot plan (drawn to scale) of the subject property (10 copies) that contains: r Parcel dimensions / Parcel acreage % Existing or proposed structures with dimensions from the structures to the prooerh/ lines i North Arrow / Street Names Scale Name of access road to site (s) i Easement(s) (P:ease submit 3 copies of document) / Public'Private P.oad _~ 6. Vicinity Map (does not have to be to scale) (10 copies) %A/DEX /l?Af _~_ 7. oa A nonrefundable application fee of S /( 3- 8. Any Drawings/Maps larger than 8'/:x14 MUST BE FOLDED NO LARGER THAN 12x9 __~ 9. ATTACH THIS CHECKLIST THE ABOVE CHECKLIST IS PROVIDED FOR THE CONVENIENCE OF THE APPLfCANT AND SHOULD NOT BE USED TO DETERMINE COMPLETENESS OF AN APPLICATION. UPON STAFF REVIEW, ADDITIONAL INFORMATION MAYBE REQUIRED. SUP_APP.doc REV 6/6195 Page 2