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='�� a�tr <br />ll'�rf'?; :n�<?? <br />.'J .�:.:s✓C� <br />.e <br />. P°,A �^e�Y! <br />1 <br />o4�Prt ° parraeAM? <br />�i' �- . �_ � ' �. :�; '_ � '.... -� � : 1 :. , ` . ' ,�;. �.. � '. <br />DEVEi,C?PIY1�i�FT ��'i.,I�'�'TI�I�i <br />240I H'a�hway I0, Iviounds Vew �,1�P 55I 12 <br />6I2-784-3055 <br />6i2-7�4-3462 -F'AX <br />�iea9e i°ype o� P�nt Inforffiatioa - Co�plete �ot� S°tde� of "I`l�i' 1�'orat <br />Applicant Inforffiatioa <br />Nacne of Applicant �/- ,�, � + )�a -� Tetephoue %�� ' y%D � <br />.�ddress , A Fa�c <br />T�terest in PraQerty (chec3c appropriat� box} <br />�� Owner of Property <br />�Q r CoQer�ct for Deed �waer <br />� Lessee, Operator, Manager <br />a A,nreeznent to Purchase <br />❑ Other{explain) _ � <br />Ap�licant� mu�t gro•ride ewider�ce of intere9t i� property at the t�ime of a�p(acation, and if you a�°e rsot the o�er of tP�� <br />propert}', you �aast pe+o�ide a Ietker of perxaissron fto�t t�e o�vner giving ctsnse�t to t4�e filing of this �pplicatio�. The <br />�rope�y ow�aer ffiust si� Yhis ap�lac:rtio� foe it to be accepted. <br />`:` i <br />Property De9c$ipteo�roposai <br />Address or General Locaeion � ai / � � �" �� �'l—�'� (�G� Y�,�� <br />Legal Description a�� oiCJ ��G� � <br />Pronerty IdensificatiqB � (PIN � —7 � Q a- � t.�- �, (�'3 �.� <br />� o# Acr�s n' <br />Current Zoning <br />Preseue Use <br />� Undeveioped/Vacant <br />� Sen.,PIc FarniIy Dwelli.ng <br />� Dupte:c�I'wo Pamily Dwe:line <br />u V1ulti-fam'tIy Dwe(lings <br />a Business/Commercial Establishment <br />� Indusuial Establishment <br />� Other (e�Iain) <br />Type of r�ppiicatian <br />� Cumpeehepsive Pla� Amendffieni �20p <br />� Rezonin� �200/ac; min 5200 ma.Y � i 004 <br />� Major Subdivision 5250 +.�z50 deposic$ <br />Q �or Subdivision 5150 <br />Q Pta�ne�! Unit De��eloprueac (pUD) �;SO <br />� PUD Ame�dment �150 <br />fl Conditional Use Pe�rmit R- I, R-2 � i 5; a.(1 others �Z00 <br />� V��� R-1, R-2 S7S; all othe:s �200 <br />❑ Code Appeat �75 <br />o Develap Review/Site Pian �[ 00/ac; miza �I00 m�ac �SUx.� <br />Q Wetland AIceration Permit �SO � de�osit* <br />Q Wetiand BuiFer Pe�it ? <br />a Fioodpiain PermiS SZ00 <br />Q Oth�x- <br />�see Municipai Code for e�cplanation of deposies <br />�1e�e co�pieie the r�verse side of t� appGs�e�o�a <br />