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OO/ -O/ LDDt oorrxi* si*» r.r%oi «cc.r.‘;i r <br />orono - V ariance appl <br />initial Application Fee S220.00 <br />(S50.00 per each additional varianc <br />Renewal Variance Fee $120.00 <br />(no ch^ge from original application) <br />AfterAe ”°^*c®nforming structures $220,00 <br />fter-the-Fact Fees (Double application fee) <br />property information <br />Application H J? <br />Date Received”^.^ 7-<7'7 <br />Amount Paid <br />n c% <br />^S <br />Or.(DH <br />i <br />T>_ w • ' ^ ^ <br />Property Identification Number (P I D) _________________- — <br />uL Of^ ^ jh'4a«m pa'rcas of Uni-------------------------------(month^ear) <br />-Xr«id„rial <br />APFLICAIV: <br />Name <br />Address: <br />K±_TL_jCq 11 Phone (home) I - ^ ^ <br />Phoiw (workX ' *" <br />OWNER (If difTercni than applicant - <br />NW TTa^J ^ <br />Address: ^UZT^ ' <br />--------------Phone (work ) ^ ‘ <br />vccnrl t. Zip: <br />tu.ft, p},Qne (home) <br />Phone (work) <br />description of request <br />Cit>:,Zip: <br />Estimated Construction Cost $ <br />variances required <br />------Lot Area ____Lqj width <br />sU<t.____________ <br />—’t~o ^ CL <br />(attach additional selects if necessary) <br />Setback; X Front Side <br />Hardcover <br />Rear <br />,Lot Coverage <br />Average Lakeshore <br />Other (.pacify) ^ <br />.r.”"”* tcquircmena: rr-y .7........ <br />% - ^ . ry r/u L,^f at f/£r ,or a.yfr <br />A- A ^ r,. /Tr-y. v 7r UrA.r^'m AtAfJTk c<^fjT ^ A <br />(attach additional, sheets if necessary) <br />Ci/T /j^7o -7//T ^n€A. y(r*:/A^c <br />^Mr (:Arr LiT^C 6f ^ 7^^^^ j-frify>a< cfF 7T' rrA. A- <br />f(:rSAc/< .