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'a <br />i OF OROMO - VARIMICB APPLICATION <br />uitial Application Fee $175.00 <br />($50*00 per each additional variance) <br />Renewal Variance Fjse $100.00 <br />(no change from original application) <br />After-the-Fact Pees (Double application <br />-/ <br />a <br />u. <br />fee) <br />V.* <br />PROPBRTT LOCATION <br />sit* Addtass SOO ri/VfOlJON) <br />,-7*7* r,c ’firkitf <br />L ^ f r W-XU'MU* <br />a^WW'^ -'V -V"'- <br />-Ti/»A I *.' • W'W <br />required survey. _ __ _ _ _3,_ _(75.0^ <br />JkPPLlCMT <br />Nanie <br />Phone (home ) H15“ ** <br />*FUj Phone (work <br />I 7t1 f a <br />,-ir .7j T <br />W'fc. ' —■ <br />< 1V1 f a V • w <br />Address t 5*0014^1^1^ H-yg City; (VA-y^/y-F^- <br />p-(if different than applicant) <br />Name_ _ _ _ _ ___ _ _ _ _ _ _ _— <br />Phone (home) <br />Phone (work) <br />Address:City:Zip; <br />Date Property Acquired (month/year) <br />1 (do) (do not) also own the adjacent parcels of land. <br />r. <br />SSBSXHT OSB OP PROPERTY <br />Present Zoning District <br />P-esent Use of Property /Residential <br />Other (specify) <br />DBSCRJPTIOH OF RBQOBST Estimated Construction Cost $ <br />Describe request in detail: <br />i:VMOMCBS H «!ii t'l.oi <br />V Lot Area Lot Width Hardcover <br />!-P <br />Setback Variances (Front Side X Rear) <br />I." <br />Other •! <br />1^-