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/ <br />I s. <br />5. <br />6. <br />7. <br />REQUIRED SUBMITTALS <br />*• Completed Application Fonn. <br />request in detail, <br />p-- (m <br />A^3. Oovenunem Cen4^4W27^ Department ofF^ <br />^ - refer to handout for survey <br />Z “eluded on required survey. <br />c^ges in elevation (gmdn). contours) if land alterations involve <br />rfdie (“elude marital status) of all ne««n» <br />2. <br />3. <br />4. <br />9. <br />viwgcs m eievauon (grades). ««eranons involve <br />' X4"“nS'ci?iSf.:4^ T^<!rr «*“■ “ i««» ^ <br />- P**"- if Wlicri.le <br />=r As m wMendom lo this .rr'->--n ri Jsl <br />PasonsyouwishnoSfiedrf thissppiiS ““ <br />TO« REPROD^TON^p“OWMENXS or copyssr- <br />WliXTn“t4ffif°rive1'«^Lu“n ^ <br />I-- Appuc-io. is «„,p,.^. <br />■----------------------------------------------- Date ■ ■ <br />APPLIC^S SIGNATURE ---------- <br />./WnUnismtor. agnj '“luested by (be Zoning <br />andtor unusual expenses incuned in leWew^f 2L JX T T' f“ P*y»^ <br />suppbed IS mie and conec* to Ihe best of <br />Applicant's signature* <br />Date v4^ <br />OWNER'S SIGNATURE <br />**»e propcl^bi*a” *)Snte***^“ “‘*.fi«*‘er authorized reasonable <br />“O*"* for puiposes of investigation a^niST^f <br />____ a . -Owitei*s signature ~~f2.'T -O <br />Date---------------------— ^ /^YO 2^ <br />Pto|^eSZu^“* c^u.^ ..— <br />rSe.“i^ *• ptS^slS^Sa'ss gs: ■srztirSa-.ri: <br />#27Q.Q