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4 <br /> -APPLICATION CONTROL SHEET <br /> h.eemplelad by G.vetapmeal.Ser�lce <br /> PraApp Only: O Yes ❑No Fes: neeelpl Number: G+1v <br /> Ftle Mmnbn: 5—`jZ- Fee: �� Reccipl Number, Geta: <br /> File Mumbm: �1•I M+- Fee; +�sig Roe+lpl Number. Gale: <br /> File Number; Fao1 `5pC Reeelpl Numb.,: Data: <br /> Gesulptlon ofPrefect r <br /> - LL1-G�l� ! Arc- f ML-. COJ7Yh.v �C•/} <br /> dcc tt 2 -7• e4vr*,- / =Avtrs Awo p <br /> %b Ce W,-M Z I.3 }zits? Fr/o/1 Ilal r fivG�iL PN rc Ttf-, Cd al% J 3 67 91fW3 <br /> Pryojoel LoceRon: 7 1t <br /> ad, Gf A < <br /> K N J <br /> Address: <br /> APN{sl: <br /> Genmal Plan Commtmiy: Genoml Plan Designallan: <br /> Zoning Mep: — P-pery Zoning: Y—,q O+arlay Zane(sl: <br /> Adjoconl 6aneml plan Zaninq qq <br /> Norah: :o <br /> //,-A, G TU <br /> Satrur: R17 /G-40 <br /> East: p <br /> West: <br /> 10D-Year Fl..dA Yea ❑NO WINam.en A.E Yu ❑No 5upervisarial 7striet 4 <br /> Ahpart Mre: 4 / Spe.M.Plccal1n{rl ❑Yes O1 NO: <br /> Igslory: <br /> „.CFIECKLIST' <br /> All Appitcollem <br /> Completed Appgeallon Forms Owned Signaluq <br /> Copy Of Reed or Preliminary This RepodCopies of Plan of Mop <br /> BY.'r I I'Reduced Plan or Map Matardvus Mol.dels Gisdasme Survey ❑ <br /> Omnlepmenl Impact Mitlgmlan Fee Fam ❑ A.+rmar and Nisiery Pages a <br /> Nomrs Llsl• Sswer/Watar"Will Sane'Leltar• ❑ <br /> Gan oral Plan Map' O Zoning Map' 13 <br /> Sails Fieparl• O Sells Sulleblliy Sludy• ❑ <br /> • Th—malad+4 may not be required lar cadoln applicalion.• Clreck She eppliceilen ype for details. <br /> Tenteswe Mops <br /> Map Sign.d by Owner load Number and Name 1Mojw Subs anyl O <br /> S,Pie All Lots Mumber.d <br /> temp.,Lino+ Laealian m Wan and Septic System <br /> Agdcvllural Ilameslte From ❑ Adjoining prapwt/Owner.Memo an Map <br /> ' Excavation ' <br /> Reclemanon Men and Sehadula q FinaracFel Gumonlee p <br /> lypieal Csnas-...11— p Elawtlon CofevlelFan Schadme O <br /> Englno..s Stamp O <br /> Completed lay: G.la: "l 1818 I <br /> - E <br /> f r <br /> p <br />