HomeMy WebLinkAboutPermit Miscellaneous 1983-10-17
FILE NO /c?S/'-c?3
~
GENERAL LAND USE APPLICATION
H.O. APPROVAL
DIRECTOR APPROVAL
Zone Change
Partition
Prellmlnary
Final
Subdivision Prellmlnary
Final
Cluster Subdivlslon'
Preliminary
Flnal
Cond, Use Permlt
Greenway Dev
PeTIll1t
Temporary Use Permlt
Speclal Use Permit
~iance
Site Review
Special Exception
Hazard Check List
Site Investigatlon Report
Special Use Permit
Planned Unit Development
Prellminary
Flnal
PLANNING COMMISSION
Request for Interpretatlon
FEE PAID\\\~S&.
COMBINATION FEE (Appllcant's opt lon-highest
addltlonal appllcation).
DATE SUBMITTED .1D\11 \ ~3 DATE RECEIVED \ 'i:)\\"h\'r3
fee plus $25,00 for each
I, APPLICANT AND OWNERSHIP IDENTIFICATION
Malling Address
SlE(JIJq~
'ZZ1fC1 ~t-vw-
Sc...I+-PtCI-\\\.I\=R Phone 14-1- 0 (, ~
('~,hJ& Cf1tf77
~C1ty J Zlp
~ Contract Purchaser Lessee
(?L
" ,
I
Name of Appllcant
Street
2
Legal Interest - Titleholder
Other
3,
S1gnatures
1"
\0. ~
I (we) have completed all the attached appllcatlon requlrements and certlfy that
all statements are true and accurate to the best of my (our) knowledge and belief
I (we) am also authorized to submlt this application as evidenced by the signature"
of the owner below,
Owner's Slgnature
,~ ~J-LO
Date
120vt83
Agent's Signature
Date
Agent's Address
Phone
Zip
II, PROPERTY LOCATION
,
Assessor's Map 17 -0:"-, - 2~_ ~7.
~^^ ~o...v....
Property Address
~~ieD-.lA. .
Place_
Tax Lot ,:,<IC)(')
Tax Code jCJ--o."-\
SOrlrv.Jldn ., (')r~ CJ7tT
I (J.... ','
Sue
I
~ '8-4 Ci.
a..c.. .
Road Status - State____County Rd ~ublic Rd,
Easement
Abuttlng Property Owned
Map
~
(acreage)
Tax Lot (s)
Present Use 0_';1 clt'fI+;r~\
Present Zonlng ~
Structures
hDl<:".e .
<;('(\01 \
s~
Water Supply - PubllC ~ Onslte Wells
Community Water System
If Communlty Water System, please 11St name
Sewage - PubllC System (list name)
Communlty System ~llst name)
SCHEDULING
Indlvidual Onslte ~
, .
Hrg Date
~eport -'Av~ilable
"