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APPLICATION FOR CONDITIONAL" USE PERMIT
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Other - spec:lfy .... . - ~4. (;) <:t'fp f
P&Z Case No. Date Received
Applicant Lffilj ..ZCl4 q" ~L Cdl
Address i~eJ? 6 ~ 7;;1,
Owner iq'r~t/ 1.t:?6by ~J\Qdress 7?( c):;
Location of project. ~ Ir P.h ~ ,2>"":',
. Phone .P ~b' ~p y' b
.
.E (;) 9~
Present use of property
Owners of property wit4in 200. feet of all property lines of subject property.
according to present tax rolls:
Name: Address:
o(80~~~....LLA-U/:4~,
Application Fee:
The .applicant certifies the above information to
If.applicant is filed by an agent, a
rney statement must be included.