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<br /> .- rho coPe3 :`• k rte,,j, t,. :.. ,
<br /> a ,Contract for Deed Owner
<br /> ----,-,C2.-, w'::Lessee.Operator;,.Manager _ •
<br /> ❑ : . ..'`Agreement to Purchase _
<br /> -Other(explain) --••:7-•••-t•
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<br /> Documentary evidence of applicant's interest in the property may be required before final.City action of this request
<br /> •_ PROPERTY INVOLVED: •.• - _ -
<br /> s. - Address/General Location r19_ ,5"- SU 1 D S A)Aly I RQ 111GU lv QS CJI0.3
<br /> ___` J Legal Description or Property Identification Number
<br /> Legal Owner: Name/Address
<br /> Present Use (check appropriate box): --__,
<br /> ❑ UndevelopedNacant _ -
<br /> Single Family Dwelling •
<br /> ❑ Duplex/Twd Family Dwelling
<br /> ❑ Multi-Family (No. of Units ) ;
<br /> ❑ Business/Commercial Establishment
<br /> 0 Industrial Establishment - _ t'
<br /> ❑ Other (explain)
<br /> -
<br /> Property Classification: V Abstract ' 0 Torrens
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<br /> RECUES T: To /?uitm .20 x iX (... 000 c�,oRK/Ai S/-icP 72) EAST" 'N d c'P
<br /> •
<br /> 'Please note: Applicant may be responsible for additional fees associated with the re i , oft ' request
<br /> I HE:ttEEY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. 1 ,yyyZy—
<br /> -Signature
<br /> *****xx*x*xxxx*x*x*xx****x*x*******xxx****xxx*****xx*x****x******xxx*****************x******
<br /> Rezoning 5200/acre,minimum $200.maximum 51.000 Park Fund Dedication Fee
<br /> • 4riar.ce R-1 to R-2-S75,all others$200 Date Paid
<br /> nditional Use Permrc R-1 to R-2-S75,all others 5200 Receipt Numberce Appeal S75
<br /> Develop./Site Plan Review 5100/acre, minimum 100,maximum $500 Total Fees Paid /� ' 41->
<br /> Minor Subdivision $150 Date Paid
<br /> Major Subdivision $250 plus $250 deposit Receipt Number
<br /> Comp. Plan Amendment $200
<br /> Wetland Alteration Permit S50 plus deposit determined by Staff Additional Fee Paid
<br /> 4111/ Wetland Buffer Permit $10 Date Paid
<br /> Planning Sign S50 Receipt Number
<br /> PUD $350
<br /> PUD Amendment 5150 Cate of final action
<br /> --- APPROVED 0 DENIED ❑ TABLED Q
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