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<br /> <br />tervi{{e <br /> <br />1880 :Main Street . Centervi[[e, :M'N 55038 <br />(651) 429-3232 . 'F~(651) 429-8629 <br /> <br />CITY OF CENTERVILLE --r?Jm~.' ~7aJ. &*/1'151 i <br />APPLlCA nON FOR PRELIMINARY PLAT <br />6/i / #.5<22 <<J Any additional costs incmred for <br />DATE PAID: . 'ZIR / 01 FEE: + Engineering, legal fess, publication or <br />. Q .~/ other I9QUirements <br />Y41. /,U)7-or LnJ. -<:Je;>=;,t-' <br />STREET LOCATION OF PROPERTY: 699:5 r-/ DW fiv'E . -j. <br /> <br />'Esta6[isfieiI 1857 <br /> <br />LEGAL DESCRIPTION OF PROPERTY: ()CL'I{u7 'f A',' /", .r?~dl~, r(Ji- <br /> <br />SIZE OF PARCEL (S): d.J;- /~ (J pC z.:;, 1-- <br /> <br />PROPERTYOWNERl..."F"Z- /)/<!.z.:>-I),,( t?,:"s L/C' PHONE#: & ')/.4;26 <Iro s., \ <br />... t, S (02 q":5 -c, 'G.. ;;'l.t e// ) <br />FEE OWNER: ! p'i k' Z /'lk' ~;~ if. r> { ;. 7/:F 0 T ,-,/ r <br />, <br /> <br />ADDRESS: ;;, ;/95 ;;2r;,Td /1--;)<:' :f,,, {/'-/T7(::"I!!.l? n1 /,/ ..i.,-<';o~8 <br />I / <br /> <br />fL~?' )I~ Z2.-41~~ <br />CONTRACT PURCHASER <br />OPTION TO PURCHASE <br /> <br />APPLICANTS INTEREST IN PROPERTY: <br /> <br />X FEE OWNER <br />LEASE HOLDER <br /> <br />,~,.' <br /> <br />DESCRIPTION OF REQUEST: -::::: fA 0,,, / / / / <j /.l / <br /> <br />- <br />REASON FOR REQUEST: C5 IS /;' ({ ;: 'b -" /. 1\ s -P,;2 c /,:,-02 '7 ) <br />/n/ /?tJJJ/\}<.L..A/{/rO'h" fj)/?-v/ ?-:r-??dd/~A!'7-' /}$/l")ij' ~_.~~ i- <br />":F ;2.,) <1/1 (/, T ., <br />/ <br /> <br />By paying the above slaIed fee, I understaM that no refunds will be issued in full or in part, at any time, even if the <br />outcome is denial ~ _', <br />/ /---'. <br />/~~i~(>v f' <br />-Signa e of AJlpficant <br /> <br /> <br />') v< P. <br /> <br />...J..-dro'69 <br />Date <br />