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='S'rI.OFK ,JT AFFLICTION FORM <br />Comorehensi.-re <br />Plan Amerdment <br />Zoning Distr:.ct Amendment <br />_ Text Amendment <br />Conditional Use Permit <br />Vax^_ance <br />Appeals <br />Trailer Park . <br />Site & P1dg. Plan Review <br />Mining na Pexmu-ts <br />Applicant (Name) A7k <br />Owner ff dl 10 Ad <br />' Name ' • <br />Simple Lot Division :c <br />.Large Lot Subdivision w ° <br />Subdivision <br />Sketch <br />vsaru <br />—Final <br />Subdivision Varian <br />Flood Plain Conditional Use <br />__. Peratt' <br />Shorelanl Pe_•-ri.t <br />Planned Unit Demelonmeat <br />• v2 � 779 �'°Yy <br />ress s y� ptron <br />Tress phone <br />property location (Street ;&dress and Legal Description): <br />Description ard./or Reason for Request (Cite Ordinance S11e��ction): <br />l hT""� tea cl f <br />� .ter !T/�m <br />hereby acknowledge that T_ have rend and £uLy urlier— <br />In sig ;,18 this application, I <br />ae Subdivision C dinaaces and current <br />stars-. the applicable provisions of the Zan zg r statements re eired from <br />the <br />adni istratire procedures. I further ac ovule gay he f e� e�laration as dd s^- <br />the aoplication procedures and hereby agree P <br />City pertai:ing to addition application emerse. <br />anL <br />