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PI 9 nnlng and Buildlng Agency ' Plannlna Divislon
20 ~ivic"~enter Plaza
P.O. Box 1988 (M-20)
Santa Ana, CA 917M
(714) 847-6804
www.aanta.ena.org
APPLICATION FOR LAND
USE CERTIFICATE
CONTACT INFORMATION
Business Name: sun( Qf svnh &
Business Address: \o \o fl, -5% v\ % . Zip Code:
Applicant's Name (print): &&'( I- Giakf Phone No.: a & - 8 3 g8
Mailing Address (if dinerent):
Present Use of Property: p
Type of ProjectlEvent: d i ~ r-t& J i h
Responsible Party On-Site Name: % 6% b M Phone No.: 651- 0 5q0
EVENT INFORMATION
Dates: ($1 lb/ Q 7 TimeMours: 5 - 6 P m
Live Music: &Yes No If yes, describe: &o4 b. rec~~dedc h
ABC License: Yes )( No If yes, describe:
Video GamedGame BoothsJComputers: Yes &ho If yes, describe:
Additional Infomation: %& d- a-\r& heQd ,- S O ~ - a05 .
TEN (10) BUSINESS DAYS ARE REQUIRED FOR PROCESSING A LAND USE CERTIFICATE.
SEE REVERSE SIDE FOR SUBMITTAL REQUIREMENTS.
Understanding and Affidavit
I understand and agree that my application can be processed for final approvals only when the following
steps are completed:
1. My plans have been reviewed by the appropriate City agencies and comments received; and,
2. Comments and conditions placed upon the project have heen incorporated into the design and
agreed to by both staff and myself.
I CERTIFY under penalty of perjury that the foregoing statements and answers herein contained and any
other information herewith submitted as part of this application are in all respects true and correct to the
best of my knowledge and belief.
Legal Owner's Name: ~A\I& ~~~ %k Phone No.:
Mailing Address: \o10 6. d d v - 9- - ax: 3 2 -81" fa
T Title: &d&K Date:
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NOTE: An agent may sign for the property owner ii a notarized power of attorney is filed with this application.
LAND USE CERTIFICATE NO. LhC '200 3 - u.6
SUBMIlTAL REQUIREMENTS
Three (3) sets of plans with the following information:
Site Plan: Fully dimensioned site plan with parking spaces indicated; landscaped areas;
setbacks; entries and exits; north arrow; streets: driveways; building structures: and oamalride - -
locations.
Floor Plan: Exact dimensions of the proposed area; the area devoted to alcohol sales, storage,
and display; kitchen area; entries and exits; computers and electronic andlor video games.
Surrounding land uses of properties immediately adjacent to the project site (land uses within
300 feet for alcoholic beverage control licenses).
a CITY APPROVALS
3 49s. c zw? .I
Fire Department: U
Name Phone No.
Condiiions/Comments:
Police Department:
ConditionsIComme
C S2Mc. 17-32 F h/K3 / / A caipA~9
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/L/ / /?A [7 DENY
Date: Signature: /// /
/ ///
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Electrical Permit Required? [7 Yes No
Planning Division: 1 2.R 7
Phorie N T
1
&WPROVE DENY Date: I ,710 ? Signature: %$$-z A //
NOTE: No permit will be issued if the use is not legally occupying the premises.
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PLANNING DIVISION FEES
Sheet 2 of 3
ADULT ENTERTAINMENT LAND USE PERMIT .................................... ........................................................... CERTIFICATE OF COMPLIANCE
C 3 PARKING WAIVER .........................................................................
HIST0RK;AI. PROPEFITY PRESERVATION AGREEMENT
( M s nppucatlon) .............................................................. HOME OCCUPATION PERMrr
Appeal ............... .-". .......................................................................
LAND 'SE CERTIFICATE
category 1
Bazaars, Fiestas, and ..................................................................... Rwnmaae Sales 7
Category 2
Sidewalk Sales, Pawn Lot Sale,
Outdoor Auctions, MU!& Medical
and Veterinary unns, Day Care
Outdeor 000th~ ....................................................... ...............
Cateoolv 3 ------~, -
Carnival, Clrous, Outdoor Musk. Con& and
Arcade, ABC Licenses
flat fee ..........................................................................
Category 4
AnteMas(Dishes
Flat fee
Plus If over 35 feet eddlUonal fee
category5
Exterior Telephone (Pay Phones)
Flrot Pay Phones .....................................................................
Per Additional Pay Phone (Each) .........................................
Qtepwy 6
Small Colleclion (Recycthg Fadlitled ........................ -........ . .
category 7
OuMoor Vending Machine (Each)
LAND USE CERTIFICATE APPEAL A o m l Fee shall be
assesed @SO% oi ~pplloatldn' Fee .......................................
OFF-PREMISE ADVERTISING (SIGN) PERMIT
~ppeal ..........................................................................................
PLANNED SIGN PROGRAM REVIEW .................................................. .................................................... ............................ Amendment
Appeal ............................................................................................
RESIDENTIAL REL0CATK)N
Appear ............................................................................................
SlQN PERMIT REVIEW (orrpremise) ...................................................
Appeal ............. .............................. ................... - ..............
TEMPORARY SIGN PERMIT .......................
TEMPORARY TRAILER ......................................................................
Appeal .............. " 75.00
UNDERGROUND UTlUTY WAIVER 169.00
$ .
Appeal ...................................... .. ............. 75.00
$
CHANGE OF AMXIESS REQUEST 15Q.W
$ ...................................................... I
LANOSCAPE PIAN REVIEW
FksidenIial Projects ...................................................................... $ 129.00
Non-Residential Pm@cts 925.00
$ .............................................................
Per Inspection aWr 2nd krspeotkn 82.00
$ ................................................
u I ntu ................................................................................................... -
TOTAL $ 1 'j 1 C' u
1: (
PROJECT ADDRESS / ' ' ' DATE I<, 1.. .:- 7 . , , . . - APPUCANT ' . ' , # . - ,
PHONE , , - ', 9 .) .I
MMLlNG ADDRESS BY I. ' i~ - ~
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