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APPLIGAT I ON FOR GOND IT IONAl USE PERMIT'
~1u lt i fam ilyres i dentla 1 project
X- Other -specify ~GIu.~/dlddp ~ct/tW
p&Z Case Number . . ,Date received .... .'f?,.?uY 5) I 9~/
App 1 i cant~<4:ZA0~<;-?1~/: '~~7Z; · Phone 31'tIJ - ~CJ&~
Add ress j(C~/ (..{~Jt~~
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Owner ~ /..., ~ ~p Address
Location of project
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Present use of property
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Owners of property wi thi n 200 feet of all property lines()fsubj ect proper tyaccord i ng
to present tax rolls: (to be obtained from CollegeStatioQTaxOffice)
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Name: Address:
Attach addItional sheets if necessary
Appl.i'.'ca t T on" Fee:
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Initials of Tax Assessor or clerk
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The appl icant certrfies~that the above information to be true and correct.
of ".....,a p.p. 1..,'.'. i...,.ca.....,n"t.....'..'.. ....0 ..W.'.'..n~e,'. .,or agent
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applic~tiC).n is flle'dbyanagent,a power ofat,torney stafem~nt must be included.
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