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• <br /> • <br /> '" ` ° :• • •APPLICATI J - NNOR SUBDIVISION <br /> 'I,`'`: � a{ • SAID JQAC�U COUNTY C(? MUNITY DEVELOPMENT DEPARTMENT <br /> i FILE NO: MS- b <br /> \c. ` V <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Owner Information _E+ngineer/Surveyer Applicant Information - <br /> IVa A f • T N,,-, <br /> Address: �O • ress: / O tA4 t L Lz OA1V <br /> �A o • • C le • <br /> Phone: Z Y O Phone:40Za <br /> PROJECT D'ESC'RIPTION <br /> _ Proposal <br /> Description of thero osed ro ect <br /> UL 7/ -F : � v � <br /> � • <br /> • • • • <br /> • = � 0 00 41 <br /> • <br /> TO BE COMPILE#ED .FOR ALL APPLICATIONS SUBMATTED UNIXR TH'E PROVISIONS OF SECTION-9-610,3(a) <br /> (Homesite Provision) OF THE DEVELOPMENT TITLE: AREA EXCEPTION IN THE AGRIhCULTURAL ZONES-* <br /> }fit a p� proect foac chtck3ne and ,ovide thRecested information}. _ <br /> ❑ Homesite Parcel <br /> Have you created a homesite parcel since At 29, 1992? <br /> ff yes, this application cannot be accepted and processed). <br /> Have you owned the property a o e An In ars? - <br /> (If no,this application cannot be accepted and processed).- <br /> Alye <br /> es, lease provide a copy of the recorded grant deed for?he property). <br /> existing single family dwelling or mobile .ome on a permanentoun a ron on t�pr �d homesite arcel? <br /> ng h- sing le famil r dwel'Gng or mobile home on a permanent foundation been on the property? <br /> ❑ Financing Parcel <br /> PROPERTY AND VICINITY DESCRIPT?ON <br /> Property Nnformation <br /> • &ber of Ex • � • <br /> - Assessor Parcel Numbers) Qroperty Size Parcels Williamp'on Act C�itoracip <br /> • ©PI- 120 • <br /> 21 <br /> ,S.y�' _f- •❑Yes*R N� <br /> Prqerty Address: Q .> 6 • <br /> t 1DEVSvs•nnirotg Appiication Forms division(Rev.05-11-09) age 3 of <br />