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PLANING API'l1:AIIrIN D.rte _7- /7 Y <br />• <br />APPLJ CANE: nacre '6aUXF, L T l.J -.. .. ..-- - phGre 7 B F • 4 , j <br />address ZS VS J •77_ �ds.44% a .l• , - ��y _rkir� V% &ere _ <br />Interest In properly (check appropriate to.). <br />O owner of record 91 le •:er, upreatur, xu,nager <br />O contract for dued o,rner, AlCagter•.ent lu purchase <br />O other (explain) ....... <br />Documental) evidence of applicant'% interest in the property r.ay t- <br />reqtlired before final city actiun on lhi% Inquest. <br />I'R01'Lr,rY: oidrobs/general 1,Kaliun - Nit /1i✓ /U. Lo 000 �• <br />!a 2 bbele r�o a r..r.o t••- d f r ,err, It..: _ -- <br />legal owner: naee/address <br />present use (check appropriate box): <br />�undrveloped fJ business establishwent <br />O single fain;ly dwellmi O industrial establishment <br />❑ duplex dwrl tiny U •µ.anmrnt. <br />n other (explain) <br />nEQUEST: (explain) Ree,?( �it�-l!<N 8-- x;3L� ilS2aJr'.L <br />e.erL---- <br />I hereby declare that the above staters nls srt• II w'.x+r <br />-j:iynature� <br />FOR OFFILf US[ ONLY: <br />BASE FEES" <br />subdivision, awior <br />("IW) <br />subdivision, minor <br />($75) <br />rezoning <br />(S50) <br />conditional use <br />($50) • SD <br />_ <br />variance <br />($5U) -_�- <br />code appeal <br />($50) <br />Subtutal <br />*Base fees In parenlheslb arc ni,n <br />refundable. <br />Park fund dedication `�-- <br />date pail _.—.. <br />Ar,G,III9-d IILS <br />.a I : i•cs <br />•.r fl. ..r,..It..•,t revl.ws <br />q. <br />sub tor.,I _ <br />IOTAL FFIS $fSV <br />date paidJ/.7-!.Y <br />rccripr 0 �req. <br />