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Application/Recpt of Pymt T_-H c~ r Y •y O_ F AC~In1I1lStI'~~:Il'e Approval of a ~~Pp~L~ '~~Iinor Atnerlding Plat Plannin~ Departni~nt ~ ~_~,h.~y.~~ 1,, r~ Y~•?~~„~£-i.! 4 ~ ~ l I. ` ,r~~-; Pai~k~~a~ E31~ ~i. ~ ` E ° C'oppell, ~I ~~a> 7~01 ~ ~ f~~1011~: l~~-iO~-i(~ i~S Filin<~ Date: ~'~~'~r:;'`~~, Fa~: t~7~ ;U-~-?U~)~ ~ b -1L1~-.__ _ I~~ilii~~ ~ce~ S2>O ~ : . _ ~ - ~ ; . ~ ~amc ot Applicai~t: ,~k'i~JS i~.w--i~i~'~` _ _ : i"=i~_ _!i%~ ~:L~ ~ r: ;',.,~.!~~i::f~_ ~ ; - - - - > _ _ . . ~ y ! ~ r . _ } , . Appircant Addr~s~: ; ~ i ~ ~ c~ ~J ; __o,!;,,~ ~ . '.a~~~ - -~'N; L : -l'`--L-~, - ~ - _ , J 7'elephone I~!umbir: ~~`~~L~2`--~'-'~D~ I~a~ Niunber. t`~` ~`'cf-r ~ - _ ~ 1 , , , ~ ~A~ L+~ _ I~ I_. r S r [~ircn Preparin~ Plat: ~~~f~.~,~.~'_~?t~~:~J , ~ lJ~f(.•~ ~ . _ . . . . . l / Address: p 7~~ ;~~~ri,~.~~~,'7=~i v;~~'-~'~~G , ~ ' F' ~-'`~r~ _ .~;^'(~rt - - i ~ r ~ "l~elephone Number: ~~t ' `-r~~ - ~-~1Ci l~a~ Nuil~ber: ~ .=111 COj'P~,S~~OilLIC'ncc~ rc~lcrli~•~~ tn Ihis upplic<~tiuit .~•~~r~ulcl bc~ c(irc~ctcc! to: Name: ~li; ~r~~C~ ~ ~i~7~_ f ,`~;,~~~._1~_~1_; Y~~'~; , r - - ; , ~ _ -l - :lddress: ~~%~i~ ;;~;~=.G~':~•'.~.~~ ~~.-"~~-~i~-. ~ _-J~ _ , f 1,~ ~ `'~yJGi'~ ~1\ llillt)~I': i ~1v :`~~ric:' Tclephone 1~uinh~r: . ~ : . , , . 1 ~ ' . c , „ - ~;;L) ' f;-~ 1 ro ert ~ Addre,s~: ~F~- ~.:~t ~ ~ i ,i_ _ ~ ~ } - ~ 1/~ Lcgal Description of~ Propcrty: ~1..~ i~i';~~~}.i_ 1 y~; % l~'`~r 7'r -~.1_ ~l~,c~~~~ ~II~~I~1~~(~- . ~ ` t~ I~Cf;S('llt ZOIl1I1~: ~ . : i : - : . ~ :,()~;:1:.}~'~ ~ ~`,~:5 ~ .~i f'roposed Revisi~ns to ['lat: ;1~t<<r~c,~2. ~-sl~rx.,Yr`~~v~ l~ ~ ~ ~ ; ~ . _ - ~~~,i; ~.,~L-";~? :.:_J U~~- ~ f~,';~;..t~ :c ' ~'~-~L1 : '-^~:.:,~:t~`:..~-~- ~ ~ 1 rC . % ~l1IJIlI1SSlOtI Rcquii~emcnts: ~l~l~ree tolded, hlach linc copie~ of t}lc N9i»c~r ;~ine»c1i»~ Plat. Stafl~will revie~~- th~ rec~iiest ~vithin 10 ~~c~rl.ili~~, cla~~ anel r~turn as .-,pprc>vc~l; :1p{~r~~~~d, subje;;t to cotiditions o?~ D~nicd. If clei~ied, r•eplattin~~ ~~i~ the pt-oE~ct•t~~ ~vill be requireci. 1 f~ a~~pro~-ed a~ a vlinor A~i~endi?~~ Plat. ~tai~f ~~~ill ~~rovide ad~iili~~t~al informati~n on requir~,cl ;tatut~~rv latl~ua<~e and signatures lhat ne~d to be included e~n th~ face of thc plat. O»~c; arE~ro~e~i tc, form. then p?~oceed ~~~ith the attached PROCEllt'RE ~O12 THE FILI~~G OF F.XE('l~"I'I~,D TI~'AL PLATS ~:\ll 121;YL:~TS. tiote: :1ll appli~atic~ns, aocui~i~nts ~I7d l.~I'ti~~ llly~> >1Ih111ltic:C~ t0 t}1~ ~~aI1J1111~,' n~~~~1CIfT1~]lt ZI'l; ~ubject to disclosure per thi,~:~; u lntorn~atiorl Act. A(ter tinal dis}~osition, the complete fiil~ ~vill be availabl~ on e Cit~'~~ -e site as ; ubli~ cfucucnenl. ~ ~ , _ , - - Owner's Si~naturc: ~ ~ ° I)ate: , ~ - - _ _ - - o~~i i i io~ ~