2004-10-12 Zoning RequestFAX N0. 7634973210
Oct. 11 2004 12:43PM P
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^ `/..C~NINC`s FtEC~[JES'I~ APPLICATION
r_m'~'~-"`ex~_.~_'_` Case No: ~' ~'
~~~~ ~,~~ _ ~ ~ ~~ ~. Base Fee: ,r
Escrow Amt: ~ 1~. ~` ~d. 4 _~ ' `1'
._.4.~.,s.~~ - _ ~,10 Date Filed: 1 ~ --~ .~- -c,"~-' _..
~~~~ ^~ ~rieasc reaa caretuuy ana answer all questions thoroughly. Uniy complete applications will be accepted
after validation by the City Clerk and prior to acceptance of required processinS fees/deposits.
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Street )Location of Property: ~ f __
Legal Description of Property
{Attach Additional sheet if necessacry): ___ ~~4-c ~ : ~- ^_
thNner: Name:
~~ ~
Address: ,,' ~ J ,=~ ,~-~ :l - ~ : ~,: ~ ~ ~ ! ~~ ..
City , . ~ ~ State: ~~'"1..' ..~ ..~ Zip: ~ ~ ~ 7
Telephone (Home~:~~ ~ ~ ~~~ _ >~- a'~(Busincss): ~G ~'~ `~,~ ~" ~~~ ~~ ~ (Fax).
Applicant (Yf other than owner):
,, f
owner: Name: ;~:=~ ~~. ~ ~'~ K ~~~ ~ °~< ..~
Address: 7,0' ~ / „_
City: ~ ~~ x., ~`~" State: f'~~'1-•.` Zip: S . ~ ~ ~J
Tele hone ~'" °` - .-c._~r`<.a ~ ~> , ~,~ ~ ~ r
p (l-lorne):.,~.,~.,~~~ (Business): ~'.`~ ~ , ;~-- ~ (Fax):
Typc of Request{s):
/ Site and Building Plan Review
Minor 5ubdivisionlConsolidation
~/ Preliminary Plat
_ Fina! Plat
Comprehensive Plan or
Ordinance Amendment
Rezoning
Variance
„~~~ Conditional Use Ferrnit
Irnerim Use Permit
Planned Unit Development
Other
Description of Request(s):
FROM CITY OF ALHERTUILLE FAX M0. 7634973210 Oct. 11 20@4 12:43PM P3
Pale Two, City of Albettviile Planning/Zoning Application
>Reason '1~Vhy Request Should Be Granted: ~'~ ~" "`~~ __. ` ' ~ _ ` Qg ~ ~ ~ ~ r, - ~.
a
Existing Us of the Property / Nature of Facility yr Business: t'
If a request for a planning/zoning action on the subject site or any part thereof has been previously sought,
please describe it below:
What?
When? , v`
Project lYame, if applicable: ~__~_ ~~, ~~~ L~r,~~ :,a ~{~-~ rr c'- ,
T hereby apply far the above cunsiderntir~r and declare thgt the inforn-ativn and materials srrbmittcd with this applicatirx~ are
in compliance with City Orr~inanee and Paticy Requirements and are complete and accurate to the beat of -rrv knrnvledge.
I understand that the rlpplicatirx- will he prvc~essed for the next available meeting Agenda after review nJ the info>rmation
submitted to determine if any other data is needed and after completion of a staff reporf.
understand that alt City incurredprofesuunat jeer and expenses associated with the processing of this reques- are [He
reeponsihility of the property owner dndlor applicant and should he promptly paid. If payment is not received fron3 the
applicant. the properrv owner acknowledges and agrees to be responsible, for the unpaid fee balance tither by diret~t payment
nr a special assessment against the property.
(If the property fee owner is not the applicant, the applicant n-ust provide wriden authnrizatinn by the nwner to make
applicannn.~
Sixty (b0} Day Waiver: The City /~ereby notifies the appd?oant drat devetopn~ent review Wray trot be rnmpteted wrtbia the
required d0 days date t+v pablie ktarutg require-ne,-ts and agency review; tberejo~, tAe City is takinK an autvmatir b0-day
eactension Jor rteveloprnent revies-: nevelnpnrerit revienr ,salt be con~pteted witkin Il0 days Ktdess the applicant approvcc
addctwaal review eCtenSiPNS. }
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Signature(s) of Owner(s): ~ `~ _ '~= ~~ /- _ ~_ ~- ~ ..,~.~..... Rata ~-' , ~ ~ `~ `~
Signature(s) of Applicant(s): ''~ _..~~6-~"'~` '~.~...._.. -- ~.,,..
Date:
Data) r: f
Date:
Approved Dtnied vy the 1'lamtirt~ Cvr»missiort on: (Date)
Approved Denied _.__ by the City Council on: (Date)
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