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City of �ilounds View, I�I�1 <br />I�evelo ment t� lication p� � Z <br />Present Use of Propecty <br />o Undeveloped/Vacant t� Sing,�e Family Dweliing <br />� Dupiexii'wo Family DweiIing � Multi-family Dwelling <br />' C7 - Business/Comrr►eeciat Estableshment ❑ IndusYrial Estabiishment <br />c� Other (explain) <br />Property Classification <br />Description of ProQosal <br />� Abstract ❑ ro�ens <br />BY MY (OUR) SIGNATURE ON 'iHI5 APPLiCATiON, i HEREBY DECLARE THAT, TO THE BEST OF MY <br />KNOW�,EDGE, TIIE INF'ORIvIATIUN PRUVIDED IS TRUE AND ACCURAiE. <br />Signature o# Applican[ � yr /�� <br />Name of Appiicant (typed/printed) �� � �-'�� � �"� ¢� <br />$ignAtttre of Psoperty Cwner <br />�;�.11i4' 4�trU�:�t;i�y vti il�: t jrz:3/���+n�jl <br />Address oi Owner <br />Phone Number of Owner <br />.._� <br />����� ��._-,l`.'���--� f-�r� ���- <br />?-! ` q� � <br />C.� 11'�. "1'� �: J �``-i <br />� °� `� Z� � � , .s���- r <br />� <br />" � �-�. �; � <br />��#����*���m����#��#*��m�*��*����m��w�*�����**���x�������**�*�����a�����x�*�w��x�r****x:�������a�x�����*�� <br />lFOit OFFICE I75� O1�I' <br />Date of Submittal - •-�� � <br />Date of Aeceptar�ce Assigned to: <br />Planning Case No. 6�-day L:mit 120-day limit -- <br />Fees Paid: Accotant # � Check # Receipt #� <br />Application: ��,�J . O� i v t.) ° .� �."� ��� / � <br />Park Dedication: <br />Deposits: � — <br />Other: <br />Total: <br />N:�DATAIGROUPS\CpMDEV�FORM51DEVr�PP.FOR � ��98 <br />