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�i�r�ning �ppfic�tio� <br />Pr�sent Use of Property <br />❑ Undeveloped/Vacant !� SingEe F�miiy Dw�liing <br />0 pupiex%iwo Family Dwelling O Nfulti-fami[}/ Dweiling <br />❑ Business/Commercial Establishment C� Industrial Estabiishment <br />❑ Other (�xplain) <br />�roperty Classi�eation � Abstract <br />Description af Proposal � <br />O Torrens <br />.:. - <br />BY MY (OUR) SIGNATUR� ON THIS APPLICAT.[ON, I N�REBY �ECL4RE THAT, TO THE BEST OF IV1Y <br />KN0INLEDG�, THE IIVFORMATIp[V PROVI�ED IS TRUE AiVD ACCURAl°�. <br />5ignature of Applicant <br />iVame of AppEican� (iypedJprinted) <br />� �/:�..�n� �� �.�'�a�M.~��._ =i: <br />[✓ r..l..:��'.` lG C� ii.�^xN i` °: �_. �-e <br />Signature af Propesty Owner _ �,�� �� - ,�,�r'°:��.,� <br />�fame of Property Owner {tYped/printed} � t � r2 (� ��s .�w- °��-�,.�,.�. <br />Address of owner <br />Phone t�umber of Owner <br />E-rnajl <br />� �"Z C� �°� .� �..c,?���:� E� ra`' <br />� .._ _�. <br />�i �' f�-- t�, �, fi ���c=��. <br />--G _ _. �,� —.. <br />%� 7 ° ��G� _a �� � � <br />�i r�•t,��,?,_ .�^M!� ��5�'"'Y,� :C`c'.,,, � �,r �r` �a.� .?��s ,� cm ,:� ani_a.. <br />� <br />��x������*������������**����*���*��*��*��*�������*�����*�x��x�*�x*�x*�*x������x*�*����x�*��x����*�� <br />� FOR OF�aC� IISE OfdlY <br />Date of SubmittaE �' " �`�! � � � � <br />Date of Acceptance �-�' �i ^ o. Assigned to: _ <br />Ptanning Case No. ��� � 6Q-day Limit 120-day fimit <br />Cs.�03- � t� '� <br />Fees Paid: Account # Check # Receipt <br /># �/ q • <br />Application: � �,.�� � 1 O �� �� � � 11 / �� __� °'�'�°-� <br />�ark Dedica�ion: <br />DeposiYs: <br />Other: <br />Totai: <br />1/98 <br />