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APPLICATION COIff ROL SHEET <br /> low! ttpp f . <br /> '# S M1 MIR���� <br /> MoApp Only: O Yos ❑ No roo: llocolpl Numbor: Dolo- <br /> r uo <br /> elo:rfio Numbor./('f5-`(3-Y roo: //(,yy llocolpl Numb- /01#6 Doload 1S(43 <br /> rllo Numbor; roo: flocolpi Numbor: Data: <br /> 1110 Numbor: foo: Ilocolpt N mbor. onto: <br /> Doscripllon of rro)ocl A. M li✓uw- 5-,q,214f"uJ nl`"PuLAT) ]a S"01 vfag- <br /> ` <br /> A 5 et 4' Jv 7WO F-At r3 <br /> L 0, W n.1 5 4fr S--t #r 2---S A-1-�7 7 Cuv'rn,r l <br /> Pro)ocl Locnllon cA 7?-c WL,3 r s( rT/K LI}Y✓L , 2�5p` N��t71�a <br /> ('`1671r MIL-C 2c2p,a, AJLgt 7 f Cr- 5T--J Ue-7-O«1 <br /> LaOi C4 ArN(s): OSy- 0 60-U( <br /> Oenmol flan Couununlly: on Dosipnollon: "Y�,- <br /> 7oukld Mnp: 50-,e-Tvj N Property zonUrp: Ovoflny Zono(s): <br /> AdInconl Oenotnl Pion zoning <br /> 1401111: A/t6- "A �y <br /> South: <br /> Ensl: ^rQ��T <br /> We'll: A _ _ A6-qu <br /> 100-Your rlood ❑ Yes-4-1,10 WIIIInmson Act ❑ Yos Pio I Suporvlsollol District: <br /> AhpodAlcn: t-dl/ Specificrinn(s)Ayes ❑ No: LANE <br /> I Ilstmy: <br /> k.:. M. <br /> ha, <br /> All Applications <br /> Complolod Appllcnllon roans Owncrs'Slpnalmo 1;1( <br /> Copy of Dood or Prollminmy 71110 rlepod• Coplas of Pion or Map 111 <br /> o''/;x I l'floddcod Plnn or Mop I Inzordous Mnlorlols Dlsclosulo Survey 0 <br /> Dovolopinenl Impact Mlllgollon roo roa11 � <br /> n Assossor and I lislory Pngos 14- <br /> Nomos List• )K-- Sowor/Wolor'Will Sowo'LOW• ❑ <br /> Gonornf Pion Mop• ❑ zoning Map• ❑ <br /> Soils floport• ❑ Solis Suitability Study' ❑ <br /> Subsidonco Arca ❑ yes 7! No Exponslvo Goll Arco Cl Yes No <br /> • llloso mnlcrinls mny not bo toqullcd for corinln opplicnllons. Chack Iho opplicnllon typo lot dololis. <br /> s <br /> Tanlnllvo Mnp■ <br /> Mop Slgnod by Owner ❑ Trod Numbor and Nnrno(Mnlor Subs only) ❑ <br /> AJ)ohdng Proporly Ownots Mines on MOP All Lois Numborod 1 <br /> Cotdotn Lincs Locntlon of Woll and Soptlo Syslom <br /> Excnvnllons <br /> floclnmallon Pion and Schodulo ❑ rinnnclnl Dunranioo ❑ <br /> Typicnl Cross-onctlons ❑ Elovnilm Cnlculnllon Schodulo ❑ <br /> Engktoet's Stomp u <br /> ComplolodDy: V6M LA Dole: (x/15193 <br /> Sall <br /> nppcu 1.nn <br />