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i .� <br /> f1l���������� - --..�� c s Noo �a-� <br /> � <br /> � `✓ � � � �����°^.� �'�'; ��' r 2 e �.O c7 <br /> �� �� ����� � �.- � �� - <br /> ���:��� _ C <br /> ����l�a������ JIL�.:�r� 0? OR0�,0 D��P U=// =T <br /> Land iise ADD�S ce�;;i or_ <br /> Stree� Location of Froperty:�r"�� , � ,,•�?� � � i � <br /> Legal Descri�tion of P�ertz*; �� `�-� (,�,�� ..�, �� / � <br /> � � r <br /> Cn•rrie r: ,�r� „� .y,r�� �, j <br /> (I�ame) (Ad.dress � {ph4ne) <br /> nPPlic��nt:�� s-r� <br /> � Name} (�ddxess ) . 1 Pho�e) . <br /> T3rpe of t�e�uestr F�ezoning <� Con:iition:l Use ?�rmi� <br /> Var�ance Ot2ier <br /> Suha.�ivision P_pprovel , <br /> Description of Reques�: � ^ ��' �� ��� � / �� _ lr�,.�,�l�jOa�.S� <br /> / . <br /> Reasor_ for Fteoues�: F'j� �� aL. /;�/��' � „ � <br /> � � , <br /> , �i� / �1��/� � . <br /> Apal�cant � Owner) � <br /> , <br /> 'rlease draw or ���acn �. ske�ch �f p�oposed s��ucture showing the <br /> following: . <br /> 1, Indicate North 6. Dimensions of provased structure �' �� � � <br /> 2a Location on Lot 7. ProPosed setba.c�s <br /> 3. Ad�acent Street Names 8. Zoning in fvrce in th�s aTsa ��-re-- - <br /> 4a � Location setback and use of ad�acent eaisting building - <br /> 5e Distances b�tween any pToposecl structvses �nd structurss on <br /> ad,�acent property <br /> Exhibit Su�gtted: <br /> �/Map or pl�.t showin� the properL,-,- affec�ed and �.il lands �ithir. 300' of <br /> tihe boundaries or tha proper�•�f ��ffecteci by proposed changea (S copies) <br /> Abstractors certyfic�L� 1�sting �he na�es �.nd add.ress ef th� ownArs of <br /> the lan� k=ithin 300' oi �he bou:-�c�aries of tn� p_operty requesting the <br /> cha��e or rezoning as zhosE nanes appear or_ the reco=c�s o; the County <br /> Auditor of Her��.ep�r_ GOU.�-!ty. <br /> Pe�itlan showin� j0;6 oi proper�y owners hi�hin 300' f�voring rezong <br /> or v�.ria'nce, <br /> ..� . . <br /> . <br /> ,. ... ._ .,... . . . <br /> �:L y>-. ..::�;. .. . . . , ._ . . � .. �. .. . . . .�.. , _...ksr..a~'�.��a...�,.�Pa::. <br />