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<br />2401 I�ghway 10, �iounds �ew �1' 55112
<br />612�7Ii-4020
<br />bI2b78493462 � FA�
<br />Please 7'Cype �� p��yi �fae�eaeion 9�o��riete �ot� Sir3e��ef Tl�es 1�'0��-- __� _-. ..._
<br />ripplica�t Informaifon
<br />Name of App[ican� ,�RNE'S � qc /L%/� � I� d E Ui4lUll�`� , .
<br />Address � _ - 5��/ Telephone ° 7 �/ �-/ � —
<br />_ ''___'t__` .."_ _ � �O � -' i� - . ..
<br />� .. . ... .w,�,..--..,..,��,,;.{ •[• _ �"h � ,� 5�4,_ Y� ` . �- F�C '_ _ .. "T� _ .
<br />. . .. . ,.... . .. . . . . .._ .. . - '..... �. _ ,: ._ .e. _._. , . _•_' _.... . .. _ . _. _ _ . , ..:,� ,r q X �' � ai-. a'rd�_. �. ..� vm� .�J....`....�
<br />_ . . _ ___�.._.. -�.�_........._....__ - - - . t...- . _. .
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<br />. . ... . .. _ . _ .,. _.....�..M.... �
<br />. _ . . . „_ _ -._..,.........:.... �_��....,,.�:���_.
<br />, Irnteresi in �ropee°�y (cf�eck apgropriatc box) _ �. _ '----.-.�-..._._ -----.--.
<br />� � Owner ofProp�ty -- _ 1 � ; Go�tracc for De�d Ocv�aer - . ` _
<br />; -. ; ❑
<br />_ o '_ Lessee, Opee-ator,Manffger� - -'_' _ . . ' . ... _
<br />Q ._ Othrr (explain) -- _ ., . __ , _ ..a . -, Agre�vae�e to Purchase �. r:_ -� - - _ , .
<br />rippdi�,ants must,pt-ovi�le eviderecs,of iatere�t i� propec°t]r��i ttse ta�xe of appGcaiion9 a�d ifyou are �xot tbe oevne�° aitlte
<br />- P�P��Y9 Yo� m�sg pr+odide � tet�r of p��is�io� f�o� t�e o�sergivia�g co�se�e to t�� %ling of t6i� �gpis°caeioe. 'I'Fa� _
<br />� _ � -. = P�oPe�tY oa�er �ua� aeg� chis app�ea�ioa for it eo bc $ccepeedo . LL- . _.: ;=, _
<br />,..1: _ - --- .. -__.
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<br />�:... �, _, ,:. _ ;
<br />—'Propeedy J�e9et�iptio�'roposal _ , sw.� . � ._ .. . . . . .
<br />�s Addr�ss or�G�eneral Loca�ion �'�j --. _.(� ._ - � -= 'D z . ._
<br />`, ,. ., � Legal Desczipaoet �. L 4 _ . _ . , � -.- _. _ t _ _ .
<br />_. PFOpeTty Td�ti�ca on�# {PTN �� � �;`; � �'�.. �� � .: F _ f._, � . R_.. : �r� ; . _ � �
<br />�� ,. ::l , ��'�' ,� 'R (a�oi/ _ _
<br />'$y` _ ., : ., � _ - \ _ �} - 4f� E � __ J �f � . ' .
<br />� ~ L f� p�..� .
<br />. . current �oni.ng . .__ . _ -- t� � %i L - . . _ . ; , .
<br />Typc of Application < . .
<br />- � CampreE�e�ve Plan A�eadmene
<br />Q Rezocung
<br />a Major Subdivision
<br />� Minor Subdivision .
<br />❑ Piannc� Unit Developmeat (PUD}
<br />Q PUi3 Am�ndment
<br />Q Co�ditio�a! Use Permit
<br />Q Variance _
<br />a - Cod� App��
<br />� o Deve(op Revietiv/Site Plan
<br />� Weelar�d Alteratian Pet�ie
<br />a Weeiand Buti'er Pezmie
<br />Q Floodpiain Pemvt
<br />� Ottt�r
<br />$250 _
<br />�ZSO/acre; msn 5250 max �ISOQ
<br />$250 + �254 d�posit�'
<br />S20p
<br />Reter to c-ezoa.i.ng fees
<br />S3�a
<br />R-[. R-2 �,75; all others �250
<br />R-1. R-2 � I00 all others �250
<br />�I00
<br />� 125/acre; mia � i 25 ��,�c �7�p
<br />. R-i. R-Z � I50: atI ottzers �200 -
<br />12-1, It-Z �25; all others $! 00
<br />�Z00
<br />---�•�•'; .
<br />'�Denosits shall be paid to cov�r al! costs ot'public notices, ma«riais aaad stat�`or consutt�nc time speac in t�e revietiv,
<br />r�s�arch or prc�aratiora of materiats assoiiated tivith this applic,aaion. Tii� applic�nc shall be resporgsible tor all c�asoIIabl�
<br />incurred cnsts in excess ot th� inttiaE deposit amouaa� Acav portion of the �posit nat a-pent or �ncumbered sha11 be r��d�
<br />ta th� applicant withzn thirty (;p) d�ys att�r considecation of th� app[icacion is compieced
<br />�ie�� coe�pdete th� r�verse �id� oithe� appiicanoo.
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