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APPLICATION FOR SITE PLk1..J'PER}1IT
}:j'ultifamily residential proj ect
~. Other - specify
p & Z Case Number;~."~J
Date received
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Applicant: . .J1~tvtV\ e. ~b~
Address: ?;dl5l> ~Avenve / hf'l1~ l-r~~
Telephone;
62 ~ ~OtPt; 6-
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Ovltl er.:
Address:
Loc:ation of prOjeet:Lot{~}~ .. .. . Block(s)
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Present use of property: LJ~Y (~J c- t)
Applicant cert
the above
Signatur~ ~fpp or agent
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APO~'JER OF ATTORNEY STATEMENT MUST BE INCLUDED.
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