PP 1980-5829i Vc�rS i Lie Of f i CC RIVd$DE COUN'T'Y PANNING DET MEN Desert Office
080 Lt�wou Street 46 Oasis Street
JinLh E'1001 Room 304
tiverside, CA 92501 ll1.0'i* Indio, CA 92201
(714) 787-6181 (714),342-8277
in the interest of processing your applicaLiun iu a timely wanner please complete this fo rm. .
Failure to provide the required information is justification for rejection of the application.
The attached plot plan check list must be fol lowcd in order for your application to be
accepted. 'Do not hesitate to contact our offices sliould any questions arise regarding your
application.
..
Name of Applicant I /V1 1 ) Phone f
Mailing Address
Street City Zip Code
Legal Owner f 7 ' . 4
Address --q i4
Proposed Use / - � � J/v , ' k ( 17 L (/
Location of property (Address if known) 41650 GME( LA X201 MA
Assessor's Parcel Numbe - 3 - 3?)o -o
Legal description of property (Give exact legal description as recorded in the office of the
County Recorder) - (May be attached)
ATTAC 14 E
0'2 fEf 0
THIS APPLICATION MUST BE ACCOMPANIED BY A NON-REFUND, BLE FILIN( F r
COPIES OF A COMPLETE AND ACCURATE PLOT PLAN AND .. f�(J'SETS OF ELEVATIONS AND FLOOR PLANS.
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx ,
PLANNING DEPARTMENT USE ONLY
qZq Plot Plan Number 04 Module Number
Supervisorial District t-L I L L-1 Zone
District/Area General Plan Area
1
Geologic Hazard Zone Land Use Element
Related File A ) %' "' --) L Open Space/Conservation
Transmittals sent to: Road \,--
(A-
Fire k,-'
Health
crq
City f ty
Date transmittals sent Return date �____
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