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AV, CM OF 01M. KMWTA <br /># i <br />�..:,. , `*Islational Use and Variance Application <br />LOCATION OF PROPOUL (or property) <br />Address /fT- ,fit Dt�!'wD <br />Legal Description <br />APPLICANT <br />Noe ! Phone i <br />Address <br />OirM <br />Ph" <br />Address <br />TYPE OF REQUEST <br />Conditional Use <br />i <br />X Variance <br />Wetlands Variance <br />RiPrap <br />.--- Fee * <br />FOR OFFICIAL USE (PLY <br />Council Action <br />Present Zoning =LA Present Use -A.S. Approm <br />Za'tift Ordinance Section Relating to Request _ I Denied <br />Specify Ordinance Aaquimunts <br />w..,, a dt" <br />Explain Aequest Aalative to Raquire■m is <br />Extent of Nla-canfior,.ity 'tj" CMZ rieAd� ab46W sJ Az& <br />Hardships to Property (Yaw reasons for iw - sting this Variance or Conditional Use Permit <br />MATERIAL MOSSAW IIOR COMPLETE f 1>PL1rATr0N <br />(Nest be submitted 1 week prior to Cotw-il Meeting,) <br />'f. ttlication completed 4,. Certified Property- Ow er's of <br />Z. VM Section wners within � `= <br />3. Survey (Sketch in proposal) from Haain County Aa= rrr of <br />Deeds <br />.4. :30.00 Fie <br />Date Si"ture P <br />�. <br />