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CM OF ORQM, NMSm <br />Conditional Use and Variance Application <br />LOCATION OP PILL (or party) <br />Address /:Z 4 5 =L A1G6,,o0D <br />Legai Description LoT z _ <br />APPLICANT <br />Nerve ax Ac 4kul c Phone f 417.7 3 o P <br />Address -1;2 <br />Older <br />Phone 1� <br />Address <br />Present Zoning ,C.P - !!3 Prumt Use <br />U sg Ohiiaa section RAlatinS to R aest 3}. 4/5" 2 <br />WE OF MQMa <br />Cm&t L al Use <br />vatlWAS Variance <br />hips <br />.3c Fee <br />FOR OFFICIAL USE ONLY <br />Cancil Action <br />Specify Ordinaa= Asgnirenents 4 oT A <br />r'^ <br />- h�5 5.6 D <br />sq, <br />k oT <br />Nplain %*lost Relative to Aegnireeier►ta <br />'(& #4RE.4 o f '90"'S w/TN A[ C �yE ii 70 R Ol.c � c EXl Sj SG�tq�� E ADF.�TikCR L L/viAi� a�v,ER��Rs —QDOF Fac,e.pat/oiv 7'ev E�/SllIV 6 3C CEI ED /N o4oPea 4&tp o S C <br />54 rT /A, AncA o- I5 ON Sug 5 r�t�vp qRe Aar "/Coy iS !y bo <br />BX"nt of NM-Cgif Zldty 1 o T Me,4 <br />s/vE Y�Ro sErB•ac� i" s y" <br />sED �trft�T/o <br />s it,4v6- <br />srs <br />sEl <br />-29.3B0 sq. rrrR t [or wiorN 77 �s�Rt <br />s.tisaRT a F ?c q v[?60 I�tuT�% j-�i 5 0 A's <br />%/) 6 SE r494ck A/k re 3 <br />for i'6*09ting this Variance or Conditional Use Perhit <br />'FAA-^,atE — MOESE 41NES AZ gsAPr t�s <br />Nootp Nor ENc*C,4cv iYeo�s LoT <br />o &Ac A Co a /N <br />EO sr4rE/OL*Nr o� o oaxe criok <br />r up PtY r,y�T/S< cope — 4,f F, 4 / s -cAw <br />r /KoQ,E <br />` MAMMIAL NK SSJIRY ICR aNPLBTB APPLIGTION <br />1 04ki st be x6mitted 1 Meek prior to Council Meeting) <br />1. Ltl'4'k;jal6PWZ. 4• Certified Property Owner's List of <br />3.(=phi) ousts within (300 ft.) (ISO ft.) - <br />��e'Phi CmmtY Registrar of <br />S. $30.00 Fee <br />Date <br />Signature <br />