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APPLICATION FOR SITE PLAN PERMIT
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Phone 2.14 '~I G.eo.o
.$ ,Tx. .:r~~ '6'.:1. \&
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P&Z Case No. SJ-- -SD <6
Date Received
Applicant L~~ e.1W~A...~
Address lJ '(dO F"~ L.\ ~. ~ ~, 1
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Owner
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Address
Architec t or Engineer L.~,
Address
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Phone
Location of Project ~"'1 V~~
Present Use of Property
Owners of property within 200 feet of all property lines of subject property
according to present College Station tax rolls: .
TO BE OBTAINED FROM COLLEGE STATION TAX OFFICE ONLY
Name:
Address:
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Attach additional sheets if necessary
Initials of Tax Assessor or Clerk ~
Application fee --~-
THE APPLICANT CERTIFIES THAT THE
AND CORRECT
Signature of applicant. owner or agent
If application is filed by an agent. a power of attorney statement must be included.