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<br /> <br />ervi{{e <br /> <br />1880 :Main Street · Centervi((e, 'JvC'l{ 55038 <br />(612) 429-3232 . ;Fa;r(612} 429-8629 <br /> <br />CITY OF CENTERVILLE <br />LOT SPLIT APPLICA nON <br /> <br />NAMEOFAPPUCANTKrY ern \~;fn{' FEE' 'fl:'\". oc; <br />ADDREsS/lr,'l \ t-'f\J1-l2')-t riv/i& DAYTIMEPHONE#{b~-(~6-\J)'g <br />DATE C1/\~ /rH_ FAX NUMBER lc:::{b (gb-'~I'1 <br />LEGAL DESCRIPTION OF PROPERTY <br /> <br />';.1"6 'hI ''2.::2. -1,!2-, " 000"3 <br /> <br /> <br /> <br />~~ <br />B JZ:~lp~ <br />Itll'~.~' <br /> <br />LEGAL DESCRIPTION OF PROPOSED LOTS /J B / <br />~.fl.d tv P}" kP <br />1) ';12,1>) :'1.1> "b - DOC '7:;. A" - ) , <br /> <br />\.!/ <br />0';'f6-~1~~ ~)~~;< ~7:- F ~,:~~jJ;:~~ ~ <br /> <br />-hJ)]- J S Q,C) '6 ,j 1 h&J <br /> <br />PROPERTY ADDRESS: <br />c,~(')<) <br /> <br />DESCRIPTION OF REQUEST <br /> <br />lo-'r- <br /> <br />(~'\ "~ <br />o L)) <br /> <br />I <br />......1) <br />.' , <br />-'I) <br />, <br /> <br />;y <br />y <br />\ ,v <br />,le9 <br />" <br />:iV <br />'~(lt <br />',., <br />i <br /> <br />( <br /> <br /> <br />j~ <br />"'/; <br /> <br />~~~I <br />Ignature of app cant <br /> <br />Signature of property owner <br />~/) ,? / O~, <br />Date <br /> <br />* Plus any additional cost incurred for legal fees, <br />Engineering, publication or other <br />"expenses <br />