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APPLICATION
FOR REVIEW AND APPROVAL OF PRELIMINARY PLAT
1. Name or identifying title, of Subdivision '5 ~ u :r ~ VJ oQ.j), "'('ER.~ Ac-E So ~c. \1 ' I
2. Subdivider: (if owner, so state; if agent or other type of relationship', state details ."
on separate sheet)
Name 5 n LJ 1:'"' H UV 0 ~ \2 \) Il ~ L &. '( ) r\ c...
Address .~ I 0 ~ ~9 lJ'-H ~ '<0 D O~f\J ~ c.~,
Te~ephone h q ~ ~ q I I D
3. Licensed surveyor or engineer:
Name
Address
Telephone
:D~"'D MA'tD
4"~OPl ~OU;-H~9Qb DQ,.
~tj3 ~~7~
C,$
4.
Location of proposed Subdivision:' 1'5 .I('J A <- e, f\J T T 0
(? (: SO \<;) ~ H .~~ (') eJ D \1 A '- ~ ~ Y S E- G T
If lU &€- S ~~
4 tic
5. Easements or other restrictions on property (describe generally): ~ E E Pc.. A- '7
6.
Names of abutting owners and owners directly across adjoining streets (include"
those in other cities): S E... € p t.... Pc- T
Requested variances. The Planning Commission j~ requested to authorize the
follQwing exceptions to its regulations governing subdivisions with the reason (attach
list of such exceptions with the reason for each set forth): ~ Q ~ F
. \
The undersigned hereby requests approval by the Planning Commission of the above
identified SubdiViSi~ ~
Signature. ~
Title P(2. e. S It> ~N T
Date Ie, f: E.. ~ rq 7/~
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This will acknowledge receipt of dollars ($ ) .
in payment of the fee for\ the above requested approval of applicant's preliminary plat.
Date
Signed
. Title
ls~s\,lS-1.:1-70
( Carbon to be retained by applicant)