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<br /> . ADDRESS77� «?. " d ' f ? : ' � Ii)_fr Eh �/ e� G � ,
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<br /> ;. ❑ - -:� Agreement to Purchase .
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<br /> : Documentary evidence Ofapplicartra interest in property beoa final City
<br /> action of this rpuYS.. 6 -
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<br /> REQUEST:
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<br /> Please note: Applicant may be responsible for additional fees associated with the review of this request
<br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE ,y 'h/' . 2Ld_-_,9
<br /> -” •. $200/acre, • um$200,maximum$1,000 Perk ford Dedication F«
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<br /> � i to R-- - I others$200 Date Paid
<br /> • •rbanal Use Pernik li R-1 to R-2- ,all others 5200 • ' - RecsiPt Number
<br /> Code Apped 575.
<br /> Develop./Site Plan Review $100/acre,minimum 100,maximum 5500 Totaf Fess Paid --- -25--D p
<br /> Minor Subdivision $150 Date Paid . -2.3-a
<br /> • Major Subdivision $250 plus$250 deposit Receipt Number 1?7 3 3
<br /> Comp. Plan Amendment $200 //
<br /> Wetland Alteration Pennk $50 plus deposit detemined by Staff Additional Fee Paid
<br /> 0 Wetland Buffer Permit510PlanniDate Paid
<br /> PUD
<br /> $50
<br /> t50 Receipt Number
<br /> $350
<br /> PUD Amendment $150 Date of final action
<br /> !� APPROVED ❑ DENIED 0 TABLED 0
<br /> Dale el - •A 7 ` 6 $ Planing Case No. V0/2_- j- Admin.Account No.
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