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CITY OF HOUNDS VIEW <br />PLANNING APPLICATION LIDate cPO j 7 <br />/t� <br />APPLICANT: Name lY� C R%%�-l� 131 gg5K1 Phone 7811-85c-)d <br />Address 1�33 /V N 9'5'd3a <br />' Interest in Property (check appropriate box). - <br />owner of Record <br />Contractor for <br />Other (Explain) <br />Lessee, Operator, Hnnager <br />Aereement to Purchase <br />Documentary evidence of applicant's interest in the property may be required <br />before final City action on this request. <br />.PROPERTY: <br />Legal <br />Locat <br />Present Use (Check Appropriate Box): S5lp U. <br />Undeveloped/Vacant Apartment <br />Single Family Dwelling Business Esablishment <br />Duplex Dwelling, industrinl Eatabliahment <br />Multiple Dwelling (3-6 units) <br />Other (explain) <br />Property Classification: ® Abstract ❑ Torrens <br />REQUEST: <br />I hereby declare that the above statements are true. A$Uk.dN • o04'w'/Y/ _ — — <br />• (signature) <br />FOR OFFICE USE ONLY: <br />BASE FEES* <br />Subdivision, Major <br />Subdivinion, Moor <br />Rezoning <br />Coudltiminl Use <br />Variance <br />Code AppenJ <br />Aitnratlon Permit <br />($150) _ <br />($75) r1S o0 <br />($50) <br />($5D) _ <br />($50) <br />($50) <br />($50) <br />*base Fcen in parenthesis are non-reiundnble. <br />Park Fond Dedicntion <br />Onto raid <br />Receipt Number <br />ADDITIONAL FEES <br />Reapportionment <br />Public Hearing NotJ.ce <br />Staff, Conaultnnt Reviews S'0.0'3 <br />Miscellaneous <br />SubtotnI <br />TOTAL FEES •LL•LS�oc: <br />Date Paid <br />Receipt Number <br />