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APS LICATION CONTROL SHEET
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<br /> To b.compleleJ by Ue velopmmnl S-1-nail.
<br /> NeApp only: 0Y.. PcN. F..: n.c.lpl Nwnbe,: D.L:
<br /> rp.Nm.b- ,-r) S -I Z- Y� Fn: 10,170 n...ipl Number 2 to Yc{ Data:
<br /> Fila Iru�nbor; `'�G F..: ZS n...1pl Number. Z/Q yDela:
<br /> FII.ll—b— F.a: necalpl it...be,: Data:
<br /> Det<dpl-of P.ol.cl M t/-c 2 s —R ow,c l o ti a PPr_rc o'no.✓ is
<br /> : nz-14Tt a /Z: AGrvF 2ETu Ew r H tlrz� ��o
<br /> P /4 Ac%fes PA (Lc�Z.
<br /> Roloct Loe 11— LO c 1 TC O O N 'Tfre' S'-v T/+ A..-o •,.��T s r PCS
<br /> OF y lZ o.4n /Tzo Fct-T -d-r-7- or (;C4--o CTZ
<br /> woo D R R-r
<br /> Add,a. 3-13 &(o W . ppGI �o 0
<br /> 003-l70 -4Z
<br /> Gcne,al Man C—.-Ay: I Genoinl Plnn Designation: A e c-t c u 1- /z-c-
<br /> Zoning Mey:(ne�ERA a 1 z Plope,ly Zoning: A��_40 0—I.y Zone(,):
<br /> Adi..cn, Gene,.l Pl.n Zoning
<br /> ll.,u,: 4c_eT=1c.u�jT_Ifze. flc.. - L}o
<br /> S..tb:
<br /> Ens(:
<br /> Wes[:
<br /> I00 Yen,Flood'R Ye. O No A(Z Willi.....Acl ❑ Ye. tlo I Supervl.o,i.l Dhhi<l: 4
<br /> Ahp—A.— 1,-�n�E Specuic Pl.n(,) O Yes No:
<br /> la.w,r. LS 4•9p'I
<br /> CIIECKLIST
<br /> All Applications
<br /> Complel.d Applie.11on Fo,ms Owns,s'Sign.lme 2(
<br /> Copy.I Deed o,P,.Iiminary Till.nepod• 'St Copi"of Plan o,Map }g
<br /> ex-.I I'n.due.d Plan o,Map �f I In,a,dou.I.Inledels Disc loau,e Survey O
<br /> D..elopmenl Imp.<I Millg.11on F..Fmm O A......,and I Want,Pages {� /
<br /> Neme.List ya St..,/W,I,,'WIII Sarva'L,11,, O
<br /> Genm.l Plan Map E EO Zoning M.p• ❑
<br /> S.N.nep.,i' Soils Suil.bllily Sludy• O
<br /> Thea m.1.d.1.m.y nal b.r.qul,.d to,ce,l.ln.ppr.lien.. Clw<M the eppli—li..yp.In,Jel.ila.
<br /> T.nle lire M.P.
<br /> Mnp Sign.d by Owner Tinel Numb.,and Nem.(M.je,Sub,only) O
<br /> S.Pi. Ali Lon fl—b—ol
<br /> Conl..Lin.. tac Location of Wall and Septic Sy.n,n
<br /> Agdcull—I 11-11.Fo,m Adjoining P,op.,y Own.n Nemo.on Map
<br /> E....11on.
<br /> neclam.Hon Plan end SehWul. O Fin.ncW Gun,.nl.e O
<br /> Typical C,o,.—11— O El—lio.C,dwl.11en Sch.dul. O
<br /> Engb,. .S..,op ❑
<br /> C.mpl.l.d Bykc IA Data: 117 3PJ CJI
<br /> .PP..,1.1.1Ln
<br /> 0(o0Z 09 0I 30 C / J0,1 9
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