HomeMy WebLinkAbout56OPERTYr'(Attach 'sep ;te sheet if necessary
j; TYPE JE A€'P!_iCAT=CJN & FEES _- -
IL_ Check all application types thw apply -City staff will determine fees.
ANNEXATION
$
_
COMP. PLAN AMENDMENT
$
_
REZONE
$
_
_ SPECIAL PERMIT
$
TEMPORARY PERMIT
$�
_
CONDITIONAL USE PERMIT
$
_
7 SITE PLAN APPROVAL
$ �rnf ' -�
v GRADE & FILL PERMIT
$
(NO. CU. YDS:
i
VARIANCE
$
—
(FROM SECTION:
- )
WAIVER
$
_
WETLAND PERMIT
$
_
ROUTINE VEGETATION
_
MANAGEMENT PERMIT
$
_ BINDING SITE PLAN
$
SHORELINE REVIEWS:
SUBSTANTIAL DEVELOPMENT
$
_
_ CONDITIONAL USE
$
_ VARIANCE
$
_ EXEMPTION
$No Charoe
REVISION
$
SUBDIVISION:
I_ LOT LINE ADJUSTMENT
$____
SHORT PLAT
S
TENTATIVE PLAT
$
_
= PRELIMINARY PLAT
$
FINAL PLAT
S
PLANNED UNIT DEVELOPMENT:
$
PRELIMINARY
—_
FINAL
1
MOBILE HOME PARKS:
$ —
ENVIRONMENTAL REVIEW
$
- AFFIDAVIT OF OWNERSHIP '- __--- ----
I, (Print Name) 0%k Je7V a-4-^ , declare that I am (please check one) _ the owner of the property involved in this application, fhe
authorized representative to act for the property owner (please attach proof of authorization), and that the foregoing statements and answers herein
conteined and the information herewith submitted are in all respects true and correct to the best of my knowledge and belief.
ATTEST: Subscribed and sworn to before me, a Notary Public, in and Q. D y 0"[i for the State of ('✓�i • residing at
SEPAt"(LE- k�1N6 eO. ,on the Tdayof
(N e of Own Representati ► .L
G to 000.
( ignature of Owner{Representative)
(Si ature of Nota Public)
(This section to be completed by City Staff.)
City File Nimber: __( I 'i . A AAD BSP CAPS CAP-U CPA CU-A CU-H LLA
TOT" FP F , _ �P 5^ ASA-H SHPL-A SHPI -H SP SM SME P V-A V-B V-H W
MHP FP D FP PP RV_
TOTAL POSTAGE PROVIDED $_ :a
MASTEFiAP.00C aewseo ei97
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