Application & check T H E C I T Y 0 F
COPPELL
Name of Applicant: x'-J A~ t°5'~-~
Site Plan Application
Planning Department
255 Parkway Blvd.
Coppell, Texas 75019
Phone: 972-304-3678
Fax: 972-304-7092
Filing Fee: ~<~rdc~O ct~/~x
Applicant Address:
Telephone Number:
Firm Preparing Site Plan Package:
Address:
Fax Number:
Telephone Number: '~2~\6c"~-"*~c~1~ FaxNumber: E-- ~bg"5~ c1~5/
All Correspondence relative to this application should be directed to:
Telephone Number:
Fax Numbe~:
Name of Subdivision or Plat: x, Jeq ~ 0 d/q~ /q ~X> XY'~ ~'-~
General Location of Property: ~c\ 7_.-
Present Zoning: ~ t~VOct-\ (_.
Proposed Site Plan Contains:
Owner's Signature:
Date:
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