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ATM
Gr-ifor" FOR OFFICE USE ONLY
B UILDING oR PLANNING
D ATE SUBMITTED: 9..% k . 1. 1
RECEIVED BY:(
CITY OF COLLEGE STATION PLANNING & DEVELOPMENT SERVICES
Planning & Development Services 1101 TEXAS AVENUE - COLLEGE STATION, TX 77840
(979) 764 -3570; (979) 764 -3496 FAX
www.cstx.gov
REQUEST FOR PUBLIC INFORMATION
INFORMATION REQUESTED
BUILDING PLANS PLANNING CASE FILE
DRAINAGE REPORT f SITE PLAN
MINUTES OTHER (BE SPECIFIC)
DETAILED REQUEST (PLEASE BE AS SPECIFIC AS POSSIBLE.) :
YEAR BUILT /DATE OF MEETING:
ADDRESS : 2o j /ajP ,L A/4-9 LOT # BLOCK #
REQUESTOR'S INFORMATION
NAME: Y / IR1 /I
ADDRESS : 4/9,09 /'/,PG
PHONE #: 977_ 77 FAX#
EMAIL ADDRESS : /pezi c4 ...5c.49,04-
In making this request, I understand that the City is under no obligation to create a document to
satisfy my request or to comply with a standing request for information. I further understand that the
information will be released only in accordance with the Public Information Act, Government Code,
Chapter 552, which may require a determination as to confidentiality by the Texas Attorney General
prior to a release. I further understand that the City of College Station has 10 working days from
the date of request in which to solicit such a determination. to
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REQUESTOWS SIGNATURE
/2 /J9 ///
DATE OF REQUEST
Official use only
DATE COMPLETED: 1 �g � COMPLETED BY: 1111.016.. A
4
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