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r «Hgeneral land use AJ^ICA^ON <br />I <br />5, <br />PROPERTY LOCATION 7 / <br />795 Old Crystal Bav Road Worth <br />nj <br />• 1 <br />V- <br />Site Address ___________ <br />Type of Application to be Filed-------- <br />Property Idcntificatk» Number (P.I.D.)28-118-23-34-00001 <br />applicant <br />Name Orono District 1278 <br />Phone (home) <br />Phot <br />AHHrexx 685 Old Crystal Bay R4-H. <br />OWNER (if different than applicant) <br />Name_________________________ <br />(wori Q 612, 449-8300 <br />City IJkkm______Zip 5S3S6 <br />Phone (home) <br />Phone (work) <br />Address City Zip. <br />DateProperty Acquired--------L96 5 --------^—---------------------------- <br />I 0 (do not) also own the adjacent parcels of land. <br />$125.00 Residential Accessory Use ^ <br />;; S2(X).00 Institutional (church, school, etc.) <br />^ $175.00 Guest House/Guest Apartments <br />' $150.00 Duplex Credit/Bldg <br />' $250.00 Commcrcial/Industrial Use <br />$200.00 Land Alteration « j . <br />■ Grading and filling * designated wetland or floodplam <br />Grading and filling * 101 cu. yd. or more <br />------- Grading, seawall, retaining walls within 75’ of lakeshore <br />PRD/PID - see Fee Schedule • x <br />$1(X).00 Renewal Fee (no change from original application) <br />--------After-the-Fact Fee - Double Current Application Fee <br />OTHER APPLICATIONS <br />$200.00 Commercial Site Plan Review (+ consultant fees) <br />'$250.00 Vacation <br />$175.00 Easement Vacation __ <br />' j 75.00 Easement Vacation With Subdivision <br />$3(X).00 Rezoning (PUD - refer to itc schedule) <br />$300.00 Comprehensive Plan Amendment <br />~ $100.00 App^ <br />Other - sec Fee Schedule____ • • <br />PRESENT USE OF PROPERTY <br />Present Zoning District _____ <br />(month/year) <br />iljy OF u^<CW <br />FlNfi^CE OFFICE <br />13S02000QO <br />01 OES <br />CHECK Ti 50.00I crcrCfT^ruAyik' vr-ii <br />rMi COJ Til: <br />A A / ’» '? <br />TA ,V <br />w* V • VV <br />Present Use of Property School Residential Other (specify). <br />6