Application & checkCOPi:'-ELL
Name of Applicant: .7'~/t' O,/~_a~..~
Filin
:ion
:ment
Blvd.
5019
.3678
.7092
Applicant Address:
Telephone Number: ~/_~'.
Firm Preparing Site Plan Package:
Telephone Number:
All Correspondence relative to this application should be directed to:
Name: ~,~. 4f,~/d~.,dl[~ .4~ie~/J/~"~- ,fdF/,,'F ~/~*
Address: ~1~1 ~r~F 3/ ,~ O.r J~
Telephone Number: ~g~ ~- ~ ~d Fax Number: ~.
Name or Subdivision or Plat:
General Location of Prope~y:
Present Zoning:
Proposed Site Plan Contains:
LandUSe No~ Of Lots or Acres for LandUse NodofLotor A~eg for
Units each Use
3ingle Family Commercial
fownhouse Retail -
>uplex Light Industrial
vIulti-Family Planned
Development
vlobile Home Floodplain
Df f ice
Owner's Signature: ~/"~'/~( ,~ ?~ ,.~(~_~
U:/Central/P&Zsrf/Submission Forms App and Checklists/Site App