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.i\PPLIC.t\TION
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FOR REVIEW AND APPROVAL OF PRELIMINARY PLAT
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1. "I'!ame or". identifying title of Subdivision: V\L~e. PL..Ac...ei'" HAt::ste;a PtzeLlrcE\.JA2'
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2. SuB'qiyider: (if owner, so state; if agent or other type of relationship, state
det,~,is on separate sheet)
Name C12.0~a CD~\lO~
Address 4\O~ \\5:r:~ . .A...v6 :t* ~G,
Telephone ~ ~ -~
3. Licensed surveyor or engineer:
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Name te~~ -~6:(t~eE1:21~ ~ 4::0'i2.\16-1'~ ~.
Address ~ UJe~,* t::2.l \..It:>. 0..1 ~~ ~ATl~~
Telephone ~~-42J"~
4.
Location of proposed Subdivision:
e. t::e
to LA.-r
5. Easements or other restrictions on property (describe generally): ~~eP~~
6. Names of abutting OM1ers and owners directly across adjoining street (include
those in other cities): ~ ~~
7. Requested variances. The Planning Commission is requested to authorize the foll-
owing exceptions to its regulations governing subdivisions with the reason (attach
list of such exceptions with the reason for each set forth): ~~ ~ ~~
This will acknowledge receipt of% ;(:4~~ ~ dollars ($07/02.60 )
in payment of the fe~ for the above requested approv~~ .l~~n s preliminary plat.
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Date . .....'Ma! I J / 6
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'Signed
Title
(Carbon to be