Laserfiche WebLink
<br /> <br />/SSO '71foill 51rccl . (clllC/,'iffc, ~l\f'A{. 55iUS <br />(r~ta{Jl's:fz"..J10')/~ (I '/)4"<) 1"1'.' 'I '(I"/)t/')l) ~ "'l) <br />~ Vii, dl 0- CITY OF CENTERVILLE ,~. '. ~. ~ .. 11.\ '. ~.( h, <br />APPLICA TION F~T COMBlNA TION/REZONING <br /> <br />LOT SPLIT/LOT COMBINATION: X <br /> <br />FEE: <br /> <br /> <br />Any additional costs incurred for <br />engineering, legal fees, publication or <br />othcr rcquircmcnL~ <br /> <br />REZONING: <br /> <br />DATE PAID: <br /> <br />FEE OWNEJ\: <br />ADDRESS:\) <br /> <br /> <br />STREET LOCATION OF PROPERTY: <br /> <br />I' <br /> <br />APPLICANT'S INTEREST IN PROPERTY: <br /> <br />FEE OWNER ?( CONTRACT PlJRCHASER <br />LEASE HOLDER OPTION TO PURCHASE <br /> <br />~~'P~~~~~~iUE~~~'~y&~~:~V~~~ <br /> <br /> <br />Signature of Applicant <br /> <br />3/~/()'-1 <br />Dat t/ <br />