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HomeMy WebLinkAboutRP 82-09; Skondroyiannis Coffee Shop; Redevelopment Permits (RP)avasidvo jo AUO REQUEST a hmm ' i ;>y^ iuym <y ^ 1 • Zone Change •General Plan AmendTient •Tentative Tract Map •Planned Unit Davelopraent •i^iajor Condoininium Penrit •Minor Condominiuin Permit •Master Plan QFia;^r Condorainium Conversion ©Major RedevelopTtient Permit (check other boxes if appropriate) • Minor Redevelopment Permit • Precise Development Plar • Specific Plan • Site Development Plan • Conditional Use Permit • Variance •Planning Commission Determination • Special Use Permit •J^uinistrative Variance Complet^..,Description af Proiect (attach additional sheets if necessary) 1 JL iLocation of Project i y Legal Description (coniplete) Assessors Parcel Number Zone General Plan Existing Land Use Proposed Zone C - 2- Proposed General Plan ly Owner Applicant Nanie (Print or Type) r*l:-3.iling Aiid tes; City and State Zip Telephone I CE.t<T.]:tY 'iilAT I m ITIE LEGAl'j aa,lRR 1^) THAT ALL THE ABOVE INP0UMATIO\^ IS TRUE Pmy COlLRh'CT 10 ITIE BEST OF MY Kt>OALEDGE. SIGNATORE DATE NajTKa (Print or .type) r^diimq Address City and State Zip Telephone I CERTIFY -muv. I m 'niii OAI^EIR'S r<EPP£SENTATTVf-r' AND Td/\T M.L TIIE ABOVE INFORMATICN IS TRUE mo CORi^ECT TO THE BEST OF MY KN0Wi:£DGE. SIGr^ATURE DATE "17 APPLICANT DISCLOSURE FORM In order to assist the members of the Planning Commission and City Council to avoid possible conflicts of interest, all appli- cants are required to complete this disclosure form at the time of submitting their application. When this form has been com- pleted and signed, the information will be relied upon by them in determining if a conflict may exist, so please ensure that all of the information is completed and accurate. If at anytime before a final action on your application has been rendered, any of the inforraation required by this disclosure changes, an amendment reflecting this change must be filed. If the applicant is an individual, or a partnership (either gen- eral or limited) or a joint venture, please state the full name, address and phone number of each person or individual (including trusts) who own any beneficial interest in the property which is the subject of this application. Should one or more parties to the application be a partnership or joint venture, then please state the full legal name of the partnership or joint venture, its legal address and the name and address of each individual person who is a general and/or limited partner or member of the joint venture. Should one or more of the parties be a privately held corporation (10 shareholders or less) or a real estate syndication, then please state the state of incorporation or syndication, corporate number, date of incorporation or syndication, corporate or syn- dicate address, and the full names and addresses of each individual shareholder or syndicate member. Should the corpor- ation be a publically held corporation, then state the full name and address of the corporation, the place of its incorporation, number of shareholders, and the name and address of the officers of the corporation. Should you feel that additional information needs to be provided in order to provide a full disclosure, please include it. If after the information you have .stibi^xttGd has been reviewed, it is aecerraxned iHat further inforrnation ^^required, you will be so adv^j^. APPLICiUlT: D\lv\\-^ 'P.v^s VKO^iQRO^ IV» ^ Name (individual, partiiership, joint venture, corporation, syndication) g^U^ STATE ^mtT CA^LCB/)I> Cfl qioor Business Address AGENT; Telephone Number Name Business Addres.s Telephone Number hEMBERS: Name '(individual;, partner, joint venture, corporatxon, syndication) Home Address Business Address Telephona Number Telephone Number Naj:ae Eome Addjress Business Address Telephone Nuraber Telephone ^luinber (Attach more sheets if necessary) I/We declEire under penalty of perjury that the information, contained in this dis- clo surtj is true and correct and tnat it will remain true and correct and n\ay be' rolled upon as being true and correct until amended. Applicant BY