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APPLICATION
~OR REVIEW AND APPROVAL OF PRELIMI~ARY PLAT
1. Name or identifying title, of Subdivision .. S Q ULT H.~ O{') P_ . \J " L l- ~ 'I 5 e~T. ~A
2. Subdivider: (if owner, so state; if.agentor otberm>e.of relationship, state details
on separate sheet)
Name v- 5 ~ t.J T '-l~ ~ {) Q \/ f!r \-.1, ~ ..../
Address '2 I 0 fi s" tJ~.t4 w 09 .D
Telephone (? q ~ - q 110
I 1"\ C I
o 2.. C. S ..
3. Licensed surveyor or engineer:
Name Del" '.D
Address '4 I Q 13
Telephone ~ ~ ~
M~ '1 ()
Sa tJ T H \JCJ () 0 Q
~37&
~~
c..s.
4.
Location of proposed Subdivision:
i e. ~,- -.a.-u4 B 11 f< -. W S2.. <2. ~.
T~A\~
WeST' oT
PQ~ Q e.~DS: A
l~'(} U ,.~ u..J ~ 0 1> \j .A- \.... '- ~ y
Q~ ~ \~~~ l1DVse
5.
Easements or other. restrictions on property (describe generally): ~E:...e..
pc..:Pt:r
41! II
6. .--Names-()f-abutting-&~Ilers-and-o'Wfters-direct1y across-adjoining.. streets. (include.
those in other cities-):.~ ~ ~ ~ p~ ftT ~
'1. Requested variances. The Planning Commission i~ requested to authorize the
following exceptions to its regulations governing Bubdivlslons with tne.l4\eason (attach
list of such exceptions with the reason for each set forth): tJ 0 ~ ~.
.8. The undersigned hereby requests approval by the Planning Commission of the above
identifi::g:~::~
Title v, Ptt-~S I C> E.~ r
Date -. I () 12-!i: /,..,~
--------------~----~--~-~-~-~----------------~-----~-------~-
This ,viII acknowledge receipt of dollars ($ -q >___
in payment of the fee for the above requestedaJ}proval of applicant's. preliminary plat.
Date
Signed
Title
las/B-12-70
(Carbon to be.retained by applicant)