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CITY OF HOUNDS VIER <br />PLANNING APPLICATION <br />Date G• /✓' Sr <br />APPLICANT: NnmeAll n. ^I ./XifI ttzt l�, E��� Phone <br />In to rent In Property (check appropriate box). - <br />Owner of Record 8 Lessee, Operator, Manager <br />Cm:tractor far need owner Agreement to Purchase <br />other (Explain) <br />Dncumentary evldenre of appllennt'n Interest In the property may be required <br />before final City nct(un on this request. <br />PROPERTY: Addrenn/General Location x?W QI J r' e, -- <br />Legal Owner: Name/Address M J aLt(Xtrq , E°r'/E. <br />Present Use (Chnck Appropriate Box): <br />Nndeveloped /Vacant A Apartment <br />Single Family pwelling Business P.sabllshment <br />Duplex Dwelling industrial Establishment <br />Multiple Dwelling (3-6 tmita) <br />other (explain) 1 <br />Property Classification: rr—�t u L__I Ab9tract ❑ Torrent; <br />MQUEST: (PxPlain) ;1c-C(4ULc LLlc-Qltltt 100(' Lt itllritIc: (letr eKLrQdr'.-( We,, <br />flits Rrlltttmttiq spice .1,.,r P..f elt;• [Jnrl': h'I, 11 VO.ti mr'e T"l.rr,i. a US <br />'Ntr! fie-edr'rl << Frafte le ,Artd'L(It? 1 ear I r'l fop one. , <br />I hereby dec.are that the above statements are true. J, �� C>? A ` ' . <br />(signature) <br />------------------------------------- ------------------------------------------------------ -- <br />FOP. OFFICE; USE ONLY: <br />RASE FFrS* <br />ADDITIONAL FEES <br />SubdivIRInn, Nnlnr <br />($I50) <br />Reapportionment <br />Subdlvlslno, Minor <br />($75) <br />Public llearting Notices <br />Rezoning <br />_ <br />($50) <br />Staff, Consultant Revlewn <br />_ <br />Conditional lire <br />($50) <br />Hlscellanenttn <br />_ <br />Varlmire <br />($50) <br />Code Appeal <br />($50) <br />Alterntlna fermi[ <br />($50) <br />*Base Fren In parenthesis <br />are. non-refundable. <br />Suhtntnl <br />Park Fund Dadicntinn <br />'TOTAL FERS <br />(late 1'a1d <br />_—_---- <br />nnte Paid <br />Recelpt. 1Limher <br />__ __ <br />Recelpt Number <br />�o1O-2frL <br />