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PLANNING AITI1,001ON <br />ApnICANr: name — l �i— CrN lfQt�:�� p^w • /�i <br />r• — <br />IntKHI lu pnyerrly (ehr.k epprnpriMr 1•r.i <br />pw.kkTF <br />n►ylik sT <br />ewwl of rlvurd kJ Icy re, uw..l u, os,na•r•r <br />G tuntraet fur dead oiwnrr Q aylrr-.rut lu purclwse <br />0 tllll{1 (rly.ldin) - —_ --- - .. -- <br />Opt yeralllalr 1eldrnaa of ypileant's interral in ow property aay 1 <br />rogvired beluro Ilnal City ottiwl inn tni• rr•rluesl. <br />atN►ess/9;nerd Inutlpn ,(.�a___LOt��yr��L i —. <br />)gal pwrwr nMlm/ad/faas .. _L1Yt �lt4� <br />Sox Le i--------..-- <br />firesoat uwr (check appropriate li <br />wldr,eluped Q bu,iness establishment <br />lu�!e fynily dwelling Q indu•tri.l ..Iablislessnt <br />Q eup,, A Jwr l l i ng O .q+drl Mld . <br />V (CFplo,n) ---- <br />(SAP IS nJ . _— — -- ----. <br />L1 MrsCr tlstlan that t11a abuwr ataterarms .re Clue. - turej— <br />FOR OFFICE USE OKY; <br />MSE FEES* <br />sdr/ivisiat, major <br />(el56)✓ <br />svNivision, minor <br />(SIS)_... <br />ramming <br />($50) _ <br />conttitlor-31 use <br />($50) .. <br />variance <br />code appeal <br />sobWtal <br />etnse fees In parenthesis art non' <br />refundable. <br />park fund dcdiriU.al <br />d..lr 1, A <br />re, r.l -• - <br />Au01111'r••t rkt: <br />puLI L. h••.rr lr.l .a)t ites _ <br />sl Jr. con•.41tu•1t revit•rs :E-.L$ <br />leis) c l lara•/m, .. <br />subtotal r_ <br />IOTAt FUSw2l%. <br />date paid Lam; <br />rccelpl / / /•. <br />a <br />