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L~~t1e Canada, ~il~tleS(7$~ PAID~~G~ <br />i"~~~~~L~~~~~~ ~~~~ Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant ~~ a.;z.w~NH y~rttv~t ~c ~~tnknrl, 2y C ~ 1.,~}'~ ~1 Ce S i - L ~ - 4jd~ <br />(Name) ` (Address) (Phone) <br />7+ ,i ,I ~1 r iI <br />Owner <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />~, Zl ®~' ~.~,~,~,~~ ~„ n.i V' L <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />,. <br />uJ cry-~-cQ "~ '" <br /> <br /> <br />Y ~7f <br />In signing this application, I hereby acknowledge that 1 have read and fully understand the applicable provisions of the Zon <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outiine~ <br />n the application procedures and hereby agree to pay a statements received from the City pertaining to additional applica <br />ticn expense. <br />(Signature f applicant) (Date) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Plamter .y*>~jm <br />Z9 39Cd CQCNC~ 3~11I~ h1I~ 949499LT59 SL~TS L99Zi6'[/4B <br />