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A4. I)P LIe A T I 0 i\f
.J..~ ~1.J.~
FOR REVIEW AND AP.PROVAL OF PRE LltYIINARY PLAT
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1.
N. am. e. Pl'. "ideIf~}ng.t,itle.Of.SllbdiViSion.,. R~r YfrL,:jl.;/HIA ...0 ? . A.. .1.t2.....C/t-f,d.--
0)- BI-L,. G~ij>(jJj)1{'r . FkJCC- .. ,clu". /, S-cJd~ 4c)-es
Subdivider: ( if owner J so state; if agent or other 1ype of relationship,. state details
on separate sheet) "
2.
Name ''"Wt~ ~ ~'~ ~.~ ~ ~t'k- h Q. t..I-~.... ,
~ddr~ss~~t?>t? t. ~:r// {~~... ~~U\, ,7"%(J/
'lelepnone . h:.1/dr4~ 9~'tP
3. Licensed surveyor or engineer:
4.
. 1\"( ....... ....~/~.. ..... '. . ~... '. 1
J. '" ama . . <.' ... '. ... ; _, tJ e:~ 8 . . ,.. '. .'.
, Address ,'~Q;A,~ ;1;~~ ~5~~7d~ ~~itpl~-
Telephone" t:J "3 "' "7 -Y.:j'<J . . .
La ti f ed Subd' · .? .... .... . · :'(2 ~C) t
.... . ea ,on 0 propo~. · ,lV1Sion:-I Uv-' 1~"~r I _~' '~. (~(4J_~}
. ~)L., ~~, ~)-q.. . ! . ,
. .
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5.
Easements o~ other restrictions on property (describe generally): _
.sCt.~ ~ L,,'""ff- .... .... ... , .... .... .' .- , ,
Names of abuttlng owners and own~l"S directly across adjoining streets (inc1u.de__
those in otheJ." .cities)= . S@.~ . ?b::::tl--: .' ... , ... · . · . _~ ..
':
6.
7. Requested variances. The Planning Commission is requested to authorize tbe
following exceptions to :its regulations governing subdivisions with the reason (attach
list of such exceptions with the reason for each Bet forth):
J.
8. The undersigned hereby requests approval hythe Planning Commission of the above
identified subdivision plat.
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Date -v.- ./(.- ...~ ?~
~ UAt, f~Jtf.!4-
--------~-----~---------------~------------------------------
This will acknowledge receipt of~ .--..r:>>Stl dollars ($ _ 1
in payment of the fee for the above requested approval of applicant's preliminary plat.
Date
.1/-/"--2'
Signed
Title
las/8-12-70.
(Carbon to be retained by applicant)