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;\PPLICATION
FOR REVIEW AND APPROVAL OF FINAL PLAT
,
1. Name or identifying title of Subdivision: t2.1i. ....~~e.Q\\L\6\~ (!)P: \..l)~ ~ I~~ -a~
l2..\C-\--\ ~~ ~1!!:>> c:>\\ll ~~
2. Subdivider: (if owner, so state; if agent or other type of relationship, state
details on separate sheet) .
Name ~ UOVAl<. , ~A~ Ce\~WEu.. ..12. COU)~eca~ ')
Address ~O. C?t?""-u..1~ e.-r
Telephone A4G... ;=Z4'Z~
3. Licensed surveyor or engineer:
\
Name~\~,,"'V;I~~t::~.~ ~ ~12.~lLV~ ~~
Address ~ Oj~ ~~. l!!)~e ~~,:lO,-,
Telephone ~~... 4Z1l:-
4.
Location of proposed Subdivision:
~e=e. ~-r
5. Easements or other restrictions on property (describe generally): ~~ ~lr
6. Names of abutting owners and owners directly across adjoining streets (include
those in other cities): ~..,Jic:.e ~\
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 wi th the reason for each set. forth): l.:)O~tEi
Signature
Title l!)U:>""~~
Date ,\0 - ~<t "'1~
Corr~ission of the above
B.
The undersigned hereby
identified subdivision
--~---~~~~~~~-~-~~-~-~~~~-~~~-~-~~--~~~~--~-~~~-~~~~-~-~-~~-~~~~~~~~-~--~-~~---~~-~--~-
This will acknowledge receipt of -rwe~1:'-{ - p\,/e;, dollars ($ ~6 ~ )
in payment of the fee for the above requested approval of applicant's final plat.
Date
Signed
Title'
(Carbon to be retained by applicant)