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APPLICATION FOR CONDITIONAL USE PERMIT
~U1tifami ly residential project
Other - specify
P&ZCase Number
rn-if8
Date received
Applicant Lv LA c. Oak. /J;/1 -=eN! ~ . Phone0'i3 .i 32.2 ~
Address '/3~gZ 1f~'1~'~:~~~.o{l~~51~+I'Q
Owner L-tJ L- A <:.. " ' 'Address .' 'fja. 1">'1~
Location of project ArYlJOiS,0 :S~. C.oPt.1~ ~4Oc4,'o..v->
Presentiuse of property
() 0.- c. O'UV\..+
Owners of property within 200 feet of all property lines of subject property according
to present ta~ rolls: (to be obtained from College ~tation Tax Office)
Name: Address:
S--a- f2A", .ef.a ~ol
Attach additional sheets if necessary
Application Fee:
o /, 0 0
Initials of Tax Assessor or clerk
The applicant certifies that the above information to be true and correct.
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If application is filed by an agent, a power of attorney statement must be included.
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