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h <br />1*1 <br />cm or OMMO - vnoakb applzcksioh <br />I;.. <br />^ r <br />*j' <br />Initial Application Fae $175.00 <br />(150.00 par aach additional variance) <br />Xnnawal Varianca Paa $100.00 <br />(no change from original application) <br />Aftar*tha*Fact Paas (Doub.' application fee) <br />#1 -a • <br />.r <br />W <br />o <br />r HWtliffr LOCATXOH <br />Sita Addraaa k.l So. <br />Vy <br />I’ <br />Iropaxty Identification liunb« <br />Attach legal deeeription to a|.*» <br />sequired survey. <br />I.D.) <br />.cation if not included on <br />I' <br />trs'-AfffUCMff Phone (home ) <br />Ml-ir^ii • <br />m C9 V*Phone (work) <br />Address» fo _ _ _ _ _ _ _ _ City; r2ip» <br />mvM.^ <br />(if different than applicant)Phone (home) <br />Vane Phone (work) <br />fc- <br />IK. <br />■I-.:- <br />AddressI City;Zips <br />IK <br />|f4.' <br />mi- <br />Date Property Acquired (month/yaar) <br />Z (do) (do not) also own the a jacent parcels of land. <br />mn MM MT n /s n <br />frM«at Sonlng District k K - I o <br />•t V. <br />Other (specify) <br />I <br />‘ • 'i • ;Bstimeted Construction Cost $. <br />Describe request in details >57^^^ <br />i s I I • ^ » <br />V <br />y Lot Area <br />•etback Variances ( <br />Lot 14dth _ _ _ Bardcover <br />l/' -- - --Rear) <br />mi": <br />iM. <br />M& <br />Otter .g it.^ .s _'ST>-««r7%: <br />m ■J