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(Co .,J ~ APPLICA TION 1 '( FOR REVIEW AND APPROVAL OF PRELllvlI}IAI~Y PL1\T 1. Name or identifying title of SubdiviSion .. /?1'/ t}t/1,*/)~/f;Z~ __ Subdivider: (if owner! so state; if agent 01: other 1;}'Pe of relationship, state details on separate sheet) " ~~::~s .8'i?l~::J~f~f;F{/IJ) !t~c ~.7Jf~/Ff Telephone ':t d-: ~ ...:? '7 /b 2. 3. Licensed surveyor or' engineer: "1 12') ~:::ss _' (e('~()?_;:;'&t//JI - -~- .- · Telephone ~,~ ;>- 77 '51 LoCati, .on 0, f proPo~ed, S,ubrliViSi, o,n: l~ ~4Ar? 7/-f<1lr~~/ ~~~:A4 ~~e;i ,Vt;Jt dlf'&?1 h,K;r,9r /J.~ j/~?~n/q, ~~: _ ~. . _ _ ~__:. _ . EaSe~~tlts, or.oth;r.. restrictions ,,0 np"r ope"r ty (deSCribe.general,ly),;_.t~~t ~Hd v~.#/4/ 4f~ v.<<7t/I!L~/:? ~/j/.bPd~~~~?~'_~_~=_: St~~~~~~e:i:A.?d.OO~;Kir:C~~?~1~;::~ s?J4nc~~~~~~~j7.-- 4. 5. 6. 7. Itequested variances, The Planning Commission is requested to authorize tb.e following exceptions to its regulations governing subdivisions witl1 the reason (attach list of such exceptions with the reason for each set forth): .... . /J2 /j/.L- 8. The undersigned hereby requests approval by the Planning Commission of the above identified subdivision plat. Signature Title / Date~1 )'76 -'- - - - - - - - - - - - - ....- - - - - - - - - - -- - - - - - - - - - - - - -...... - - - - - - - --- - - - - -' - - -, - -- This willacknowlerlge receipt of dollars ($ -L in payment of the fee for the above requested approval of applicanttg preliminary plat. Date Signed Title la8/8-12-70, (Carbon to be retained by applicant )