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<br /> <br />tervi({e <br />T.stablisliul 1857 <br /> <br />1880 9rl.ain Street . Centerville, 'M!N .5.5038 <br />(651)429-3232 . P~(6.51)429-8629 <br /> <br />DATE PAID: <br /> <br />CITY OF CENTERVILLE <br />APPLICATION FOR PRELIMINARY PLAT <br />Any additional costs incurred far <br />FEE: ut4-, V G'b + Engineering, legal fess, publication or <br />otberreauirements. <br />2.. ~~ Av -c.-'\ "'.. _ <br /> <br />STREET LOCATION OF PROPERTY: <br /> <br />LEGAL DESCRIPTION OF PROPERTY: <br /> <br />~H~~d <br />- <br /> <br />2.4 - 31- 2..2 -23 - ()DI<.f <br /> <br />1 t) ;) () - ZJS~ D-\I...o <br /> <br />,- <br />.,,~. <br /> <br />SIZE OF PARCEL (8): <br /> <br />r;Jl <br />~- <br />I "'. ~ <-- <br /> <br />PROPERTY OWNER: Q,1 ~ , PHONE #: ~ t3J - t/ 2-9#1. t..~ "L, <br />FEE OWNER: (2., +-1 b+' ~\~i ~ l-e.. <br />ADDRESS: I <:q 'f 0 M c...; -- <;;{.. , <br />APPLICANTS INTEREST IN PROPERTY: <br /> <br />E- FEE OWNER <br />LEASE HOLDER <br /> <br />CONTRACT PURCHASER <br />OPTION TO PURCHASE <br /> <br />DESCRIPTION OF REQUEST: <br /> <br />.. -' .;t <br />g-v..L 1. .., fS I ~ <br /> <br />~~;~~~ <br />~1<: .~ ... i~ <br /> <br />REASON FOR REQUEST: <br /> <br />By paying the above stated fee. I llIldt:IlItaW that no refunds will be issued in full or in part. at any time, even if the <br />outcome is denial. <br /> <br /> <br />s&.. ~;;C: =----. <br /> <br />j1~ <br /> <br />Signature of property owner <br /> <br />-. <br /> <br />1.. -"'l-1-0J- <br />Date <br />