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APPLICATION FOR ':'~W'illlFJ,XI =t'PERMIT
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residential project
Other - specify
p&Z Case Number
---
Date received
App I i cant ~N'DLC;: C()R?
Address 1735" 32/Iff:..CfU5T
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Phone 779-~;;c;~
j) D. /30;<;' 3 'f t 'l.
Owner ~2..,e &t~/<);J;c /Lc,",/b'~k' .Address
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Location of projectio75 /- :2 J &CK-'iC So
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S'l""<2. 17 Q..'\J
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Present use of property
t
o property within 200 feet of all property lines of subject property according
resent tax rolls: (to be obtained from College Station Tax Office)
Name:
Address:
.::.::.;
Attach
sheets if necessary
Fee:
Initials of Tax Assessor or clerk
The appl icant certifies that the above
information to be true and correct.
8./u~
(ignature of appl icant, owner,
or agen t
If appl ication is filed by an agent, a power of attorney statement must be included.
If
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