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-' i SRN it C City of San Les . :o ro :. _ h °%moo ° PLANNING=PERMIT � p Planning Services L', g;F s= 835 E. 14th•Street •• San Leandro, CA 94577 APPLICATION �: 444.,N70 PH (5,10) 577-3371 FAX (510) 577-6007 Please type or print legibly. 2 63� 4ue Toy). — 9/oz-/s- ;'� Project Address: !i CT�(Iit f Assessor's Parcel Number: ., Please check all applicable permits. 0 Conditional Use Permit ❑Fence Modification 0 Planned Development 0 Site Plan Review: AVariance 0 Zoning Map Amendment 0 Other A Major 0 Parking Exception 0 Tentative Map A Minor 1 A RS-VP Please describe the roject associated with your application request. (Attach additional sheets if necessary.) 50 4 t.0 (.[ )t 1-Lc!6Lvl2 — V ` -. ' - C% .�j • ' I / . 4 /,� . . • , f. . .e -• ' /r ,i' • .� J i / __ i Ir C% -s 1,-; - Please provide a supporting statement for your application request. (Attach additional sheets rf necessary.) r J • Applicant([34wner 0 lessee 0 other) : , Legal Name(❑individual 17-Cbrporation 0 joint venture 0 partnership )% ,U r4. 6) /4e1 • Mailing Address: 2 S 3 T 6y.cl4.4 71-11(Je-- Work Phone: (570) • a 3 $ ga/02 ' City: Scut► C rn c VState: C,f Zip: 9415-11 Home Phone:WV 396 21./23 Email Address(optional): JoLc(S 1) lad((u.c • Cio44f Cell Phone: (V7 376 .t• 3 I (We) hereby certify under penalty of perjury that I (we)join In said application nd that the statements and information contained herein are in all respects true and correct I `�/ Co G t//5 �G A-ab, Date: /14t rC)� /2 Applicant's Signature: Property Owner(if the applicant is not the owner): Legal Name(❑individual 0 corporation 0 joint venture 0 partnership ): - Mailing Address: Work Phone:T. 1 . . City: State: Zip: Home Phone:f': '_) 'Email Address(optional): Cell Phone:( ) I (We) hereby certify under penalty of perjury that I (we)join In said application and that the statements and information contained herein are In all respects true and correct. Date: Property Owner's Signature: • ��7//', TO BE COMPLETED BY CITY STAFF Project/4: PLN ' V - I I r06 Date/Received: 'i4r)!j/ By.Q4f Zoning District: . ./ Fee/Deposl ,�J — 3 , 5 Reviewing Body. / i paid: ,'Z,.70( , Code Section: 3 Receipt Hearing Date:,- —7---. ./ # - 'J o J r ) Redevelopment: 0 Plaza 0 Joint 0 WSL/Mac Areiret5(..- Customer#: 2---3 4;0 S Environmental: 0 Exempt 0 Neg Dec 0 EIR r/� 4_ - /-20/3 co Staff Comments: / ,- " ` Q( �.4- +.�`��/ /�� , IIjU!- - . o o - COMMUNITY DEVELOPMENT DEPARTMENT v/ a w-ww.ci.san-leandro.ca.us .