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aj Aui S <br /> -a dre sa'i a'$3:� - .x'•►�t°�3+�'�rd"b$ ' 3`� �. _{,a ¢ �T <br /> z Otte , R -z �4 <br /> -APPLIGANT �f1e`�( ac, Ot'tGC � c_ i�,� }� -z _`Phone-�$O <br /> • 4 <br /> ADDRESS 55OS �`�►i ncy �� �ounr,.5ui ra) Mt S S 1 <br /> Street Address, City,State,=and <br /> Interest in Property (check,'appropriate box) <br /> �, r, ,- Owner-of Property <br /> Q - Contract for Deed Owner <br /> ❑ Lessee,,Operator, Manager � , <br /> ❑ : Agreement to Purchase _ <br /> ❑ ` Other (explain) <br /> Documentary evidence of applicant's interest in the property may be required before final City action of this request <br /> PROPERTY INVOLVED <br /> Address/General Location 550 S_ Qurr,cy .M. Qu D rin eh , L <br /> Legal Description or Property Identification Number So. 23 L.4 i h 1 TA EXef <br /> l . So / T`1 D J %. %G , t'ArNZS. <br /> Legal Owner: Name/Address '7T6: /I1�uN7"u.in1 577/-7ES 7 GF)T S <br /> iiqsd 4- U /a:7 i P 5Se,(/j%Z_ <br /> • Present Use (check appropriate box): <br /> 0 UndevelopedNacant <br /> Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling <br /> ❑ Multi-Family (No. of Units. ) <br /> ❑ Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> Q Other (explain) <br /> Property Classification: 0 Abstract ❑ Torrens <br /> R7 EST: ` '(G'1 /c x .e� <br /> , <br /> 3AO,i <br /> *Please note: Applicant may be responsible for additional fees associated with he review of this r-•ues <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. l <br /> Signa(ure <br /> ******************************************************************************************** <br /> Rezonin• $200/acre, minimum$200, maximum $1,000 Park Fund Dedication Fee <br /> R-1 to R-2-$75,all others$20 Date Paid <br /> - • lona es- Permi R-1 to R-2-$75,all others $20 Receipt Number <br /> ode Appeal $75 <br /> Develop./Site Plan Review $100/acre,minimum 100,maximum $500 Total Fees Paid 0 • erb <br /> Minor Subdivision $150 Date Paid -9 <br /> • Major Subdivision $250 plus $250 deposit Receipt Number �� <br /> Comp. Plan Amendment $200 <br /> Wetland Alteration Permit $50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Buffer Permit $10 Date Paid <br /> Planning Sign $50 Receipt Number <br /> PUD $350 <br /> PUD Amendment $150 Date of final action <br /> APPROVED 0 DENIED 0 TABLED 0 <br /> — q tet___:__ n___ si_ .Z O — �II- n, _.. n — Al. A iI A <br />