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APPLICATION FOR CONDITIONAL USE PERMIT
~ultifamilY residential project
Other
specify
App 1 ican t
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p&Z Case Number Date received
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Stl-'111.Z. Ad d res s
01/(2..,/1 Phone
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Address
Location of project
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Owner
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Present use of property
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Owners of property within 200 feet of all property lines of subject property according
to present tax rolls: (to be obtained from College Station Tax Office)
Name:
Address:
Attach additional sheets if necessary
Appl ication Fee:
-0-
Initials of Tax Assessor or clerk
The applicant certifies that the above information to be true and correct.
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Signature of appl icant. owner. or agent
If appl ication is filed by an agent. a power of attorney statement must be included.
XI-565"