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APPLICATION FOR SITEPLAt'i PERMIT
./ Multifamily residential project
Other - specify
P & Z Case Number &.....5IttJ Date received ?fiw~ .
Applicant: l1J,cira-e-/ t '~e? ~. f).arrell {:;;r/e,-
Address: r:- 0, f70x
OWtier.: .. 61JVI fJ"Ie; (ell )<; Address :. \ \ 0 V\' I~ ~("'i~
Location of Project;: Lot(sy~lA'fO~i~<>.t~lock(s)
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Telephone: ~9~'" J?I r:?9.
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Present use of prope~ty:
Applicant certifies the above information to be true an
IF APPLICATION IS FILED BY AN AGENT, A POWER OF .ATTORNEY STATEMENT MUST BE INCLUDED.