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cm or OMHO VARZMCI AmZOiTXOH <br />Initiallitial Application <br />($50.00 por aach addit <br />$175.00 <br />par aach additional variance) <br />Ranawal Variance Pea $100.00 <br />(no change fro« original application) <br />Aftar-tha*Fact Paaa (Double application <br />PMnm LOCATXOd <br />Site Addraaa_____33\0 <br />Property Id.ntiflcatlon Nunbor (P.Z.D.) ^ <br />Attach legal deacription to application if not included on <br />required survey. <br />cm IF OHM <br />OFFICE , J3S020m * <br />01 CEH M <br />CHtiX 1L 1 ISM HECEiPT-mK m <br />KiSSiSO COOl <br />APPLICAVT <br />Nana ^ ^ ^ ^ <br />Phone (home) (^13- M13- <br />Phone ‘'31* <br />Address: 3'ilC AA Citv: cic>-a rn A Zioi 6S5S(r <br />ONHKR (if different than applicant) <br />Name <br />Phone (home) <br />Phone (work) <br />Address:Citv: Zip: <br />Date Property Acquired (month/year) <br />Z (do) (do not) also own the adjacent parcels of land. <br />PAEsntT USB or psoPBrnir • <br />Present Zoning District lie. <br />Present Use of Property ' Residential) <br />/■ <br />Other 'specify) <br />DISCIlIPTIOli OF RBQUBST Estimated Construction Cost $lo.ooo <br />i.0 <br />VAUAKBS RBQUIRXD <br />Lot Area Lot Width Hardcover <br />Setbac)e Variances (Front X Side Rear) <br />Other • <br />J