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APPLICATION FOR CONDITIONAL USE PERMIT
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~1u.l t i fam i lyres identi alproject
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p&Z Case Number Date rece i ved q @o f~'b
Applicant :r ~1insl<..; Phone bqb~5'1 ~q
Address Rt.1f aD GrlU\Tr.u.tf. ~&lud';H'
Owner WiJ2Jlc. St~CbYf. .. . AddressC.~iv~~Dr.
Location of project. . . .. l~DO [brothtrs~\la. 1r.~5ia..+~Crrv
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Present use of property
Vntful+
Owners of propertywithi n 200 feet of all property 1 i nesof subject property according
to present tax rolls: (to be obtained from College Station Tax Office)
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Name: Address:
Attach additional sheets if necessary
Appl ication Fee:
Initials of Tax Assessor or clerk
The applicant certrfies~that the above information to be true and correct.
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Sig';;Uture of applicant, owner, or agent
If application is filed by an agent, a power of attorney statement must be included.
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