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PLANNING APPLICATION <br /> Ldi e Ct+tiacr- <br /> APPUCANT: /to , .—_,I2 (A). s t"V'444LIC# <br /> Phone -.2-6" <br /> ADDRESS: -1—Y-7,1-4)4'15 S r211..) —_ <br /> Street Address, City, State, and Zip Code v,f M� ��� <br /> Interest in Pro Qarty_(check appropriate box): <br /> Owner ofProperty <br /> •/ <br /> ❑ Contract for Deed <br /> Owner <br /> ❑ Lessee,Operator,Manager -❑ . Agreement to Purchase - - <br /> ❑ Other(explain) - • <br /> - Documentary evidence of applicant's interest in the property may be required before final City+=Son of this request <br /> - PROPERTY INVOLVW. -- <br /> Address/Genera! Location SSt7A- ana.,t 5 ff.; .4/0u...4s ✓if� Hr✓ 3Si'd <br /> Legal Description or Property Identification Number_/1.4ois ty coyt,-y c� f c <br /> 44-4, 5,14✓E 3: - 9 <br /> Legal Owner: Name/Addressfr <br /> H• . RI t�t.di>a 2o9f/Li �G-4-i3f�1 -10,1-5-7 �. 5�p' 20.9 <br /> wte.r_rFa✓5 riaj /lay.,/ /2404r2 A ai"y vif <br /> NnJs, <br /> Present Use(check appropriate box): -- <br /> ❑ UndevelopedNacarlt <br /> ❑ Single Family Dwelling <br /> Q Duplex/Two Family Dwelling <br /> ❑ Multi-Family(No.of Units <br /> ) <br /> - - 0 Business/CammerdalEstablishment <br /> ❑ Industrial Establishment - <br /> - Other(explain) �� <br /> Property Classification: f7 Abstract Torrens 1 <br /> • <br /> RECUEST: Fee ,ok/2n-,iSS.aa) TV 6a/4.....0 4,1-) e,�ar917,63 A•) 77o.t. <br /> ry 77 ''-'474 S 3, of <br /> PXrs`.t/ S,yL✓cTvn <br /> °please note: Applicant may be responsible for aaoitiorW fees associates with the review of this request <br /> I HERESY DECLARE THAT THE ABOVE STATEMENT ARE TRUEf <br /> iCtIL r-/ <br /> .......................... <br /> � <br /> Site-7 <br /> V aRezo� S200/aore.minimum 3200.maximum 51.000 Perk Fund Dedication rte ' ! <br /> R•1 to R.2-$75.al others$200 Dees Paid <br /> Conditional Use Nand R-1 is R-2-575.all others$200 <br /> Code Appeal 5.75 Receipt Number <br /> Deveop.iSite Plan Review it00/acre minimum 100�.jma m 5,500 Total Pees Paid Ij /Q,� <br /> Mince Sulpoivialort si ✓`-1.C✓T� ES Dme Paid <br /> Mao,Subdivisiott $250 plus 3230 deposit <br /> Coma Plan Amendment $200 Receipt Number i-� <br /> wetland Altrrton Permit $50 plus clamed determined by Staff Additional Fee Paid <br /> Wetland SurferPermit $10 DatePaid _________ <br /> Plannmq Sign • <br /> 550 Receipt Number <br /> PUD $33 <br /> PUO Amendment SIM <br /> Dau d find 77.4'APPROVED DENIED L' TASLD Ci <br /> D'm \)(Ar/e' Ill iqq& Planning case No. `'rt i '1 °tAdm -tal <br /> Admin.Account No. rl <br /> • <br />