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PLANNING APPLICATION Date <br />APPLICANT: newt _(� ,.,.k KNn��S t'... UCr1_ ____ phone Z-41 <br />address 1t ' is A 3SZ' -1 3 <br />interest n pruparty (check appropriate bo+). <br />Aelo".er of record 0 lessee, uprritur, manager <br />Cl cu..lract fur dead owner ❑ up erawnt iu purchase <br />O'othcr (explain) t'AA tl,r /b',+r. /Ir <br />Doeuernt.,,y evidunce of applicant's interest In the property may I <br />required before final city action on this request. <br />PkOPERTy: liddress/, ,mral Iglatl W, � F'_.ii/ .i. �ij. �Le'_.�.frfJ-[ll • • r <br />nAl <br />legal ow.- •r: name/address �,a .� �..! O.__ <br />present use (check appropr ute box): <br />0 urdrveluped ❑ busiues► rstablislratnt <br />13 si,,gle fanlly dwelling 0 Industrial -.1ablishment <br />M duplex dwelling p apartment, <br />O ott,er (explain) <br />REQUEST: (axplaln) <br /><-- <br />I hereby declare that the above statements are true. <br />FOR OFIICE USE ONL`:: <br />BASE FEE`" AUOI110IIAL TEES <br />subdivision, maj,r ($150) 1S,9.JJ <br />subdisisior, mit�,r <br />($1S) <br />rezoning <br />conditional use <br />WO) <br />variance <br />(550) <br />code appeal <br />($50) <br />L <br />subtutal <br />7s, pO— <br />Irate Ras In pa ,nthes(: <br />are non- <br />refundable. <br />Park fund dudicalioll <br />(❑� <br />date I. id <br />— s <br />race Iv1 1 <br />_ <br />reappurtionnwnt <br />public M•atintl uotires <br />%i.,ff, cun,ultant reviews <br />.ni s,, IIan,-,.,r, <br />f subtotal <br />TOTAL FEES <br />date paid �L _ <br />receipt / 1 <br />r r <br />