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CITY OF HOUNDS VIEW <br />PLANNING APPLICATION <br />--. // Date <br />, ePLICANT: Name •JON•y .�Oas6£,PG _ Phone Sy'/- 7741 <br />Address r �J< ��• FA4ZA /?LOG /%Ptt. u53y/g <br />Interest In Property (check appropriate box): <br />Owner of Record Q Lessee, Operator, Manager <br />('nnhrartor fpr ncod nunnr IJ Aparement to Purchase <br />❑ Other (Explain) <br />Documentary evidence of applicant's Interest Er the property may be required <br />before final City action on this request. <br />PROPERTY: Address/Genera! Location S)o LGte'.✓VX eO <br />V. TNB C / <br />Legal Owner: Name/AddresslS Ht J�s Aa7df <br />Present Use (Check Appropriate Box): <br />Undeveloped/Vacant Apartment <br />Single Family Dwelling Business Esablishment <br />Duplex Dwelling Industrial Establishment <br />Multiple Dwelling (3-6 units) <br />Other (explain) <br />Property Clascification: ❑ Abstract ❑ Torrena K (%-wA,-XJ <br />REQUEST: (E:,pl.ain) iyirt. awe fPiy1 L 01RP ArrleyG <br />I hereby declare that the above statements are true. ��" r <br />(signs Use <br />FOR OFFICE USE ONLY: <br />BASE FEES* <br />Subdivision, Major <br />Subdivision, Minor <br />Rezoning <br />Conditional Use <br />Variance <br />Code Appeal <br />Alteration Permit <br />($150) <br />($15) <br />($50) <br />($50) <br />($50) <br />($50) 5u <br />($50) <br />*Base Fees in parenthesis are non-refundable. <br />1 <br />Park Fund Dedication <br />Date Paid <br />Receipt Number <br />ADDITIONAL FEES <br />Reapportinnment <br />Public Ilearting Notices <br />Staff, Consultant Reviews 2 S P <br />Miscellaneous <br />Subtotal <br />TOTAL FEES <br />Date Paid <br />Receipt Number <br />