Laserfiche WebLink
0 rki P ki <br />0 (7 <br />terve <br />CITY OF CENTERVILLE <br />APPLICATION FOR LOT SPLIT/LOT COMBINATION/REZONING/SITE <br />PLAN REVIEW <br />Any additional costs incurred for <br />LOT SPLITILOT COMBINATION: FEE: engineering, legal fees, publication or <br />other requirements <br />I <br />SITE PLAN REVIEW: <br />.................................... <br />STREET LOCATION OF PROPERTY: 7/ 3 rn <br />1,EGA.I., DESCIZIPTION 011F PR.101113]ERTY. ,./ . ......... .......... ................. ........ ...... ............................................................................. . . ... <br />619JNJ��� <br />PROPERTY OWNER.: <br />Q <br />FEE OWNEI <br />ADDR]IF3,SS: <br />11.'02 . .............. 51 T L' Irla n4r.'.. <br />I.. I . ........ eX 1�� r 1r <br />APPLICANT'S INTEREST IN PROPERTY: <br />........... y FEE OWNER CONTRACT PURCHASER <br />........................................ <br />'"� �"" � <br />LEASE HOLDER OPTION TO PURCHASE <br />DESCRIPTIONOF REQUEST: .......................... . A . ; / . . . . . . . ... . . . . . . . . e . . . . . . . .. . .. . . . . . ..... ....................................................................................... <br />"s) <br /><111 .11,111,111,11, .- ............................................................................................................................... . ....... . . .. . ......................................................................................................................................... . .... . .. ....... . . . .............................................................................................................. <br />"X ............... ......................................................................................................................... . . ............................................................................................................................ . .. . .... .... . . ....................... <br />.... . .......... ................................................................................................................................ . .... . .................. ''I'll,''','''', ............... .. ..... . ....... . ...... ............................................................................................................................................. <br />R4SON 170)i� KEQ�JES'T: ........................................ <br />By paying the above stated fee, I understand ffiat no refunds will be i-psued in flill or in part, at any tu"ne, <br />even if the outcome is denial. <br />,'Si.,gn.a.t,if,",A,.ppp,lic nt fire of Pix) -wr S gna ) . jpcT�j lir <br />C- <br />............ <br />111.)ate <br />41� 11""' <br />