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<br /> <br />RECEIVED <br />SEP 1 0 2004 <br /> <br />ervi[[e <br /> <br />1880 Main Street . Centem[[e, 'M!J{ 55038 <br />. 'EstaGfisned 1857 CITY OF CENTERVILLE (651) 429-3232 . :Fa>c (651) 429-8629 <br />APPLICATION FOR LOT Sl'LITILOT COMBINATIONIREZONING. <br /> <br />STREET LOCATION OF PROPERTY: <br /> <br />00 Any additiOIllll costs incurred for <br />FEE: ~ + engineering, legal fees, publication orO . <br />. " oilier requirements,lf- b'1nw, <br />DATE PAID: 9)oh/ ~ //6tF ~ <br />. / . 7.,&, r <br />dO-tb /tilL S", b:.J~.:II-zz.-.3;(-t;{JO,L <br /> <br />LOT SPLIT/LOT COMBINATION: -X-- <br />REZONING: <br /> <br />. <br /> <br />LEGALDESCRlPTIONOFPROPERTY: - tb-<-T aI;- .sw '/4 c~ SE '/~ of;- <br />~.,:}:3 'V'dlj &so o~ G" Us,", <br />. . l~.s... .. UJ 'i'~~T.,(: tJ~ll<l or;. $EI/<j- (J<;;- ~2.3 Vn.-"T O-Q. c...usA a.ilL <br />17..,--,.. ",.Ii' N~ '1<\ ~ 51>) '1<+ eJ;.- ~~~ <br />SIZE OF PARCEL(S): . O~ O-L. <L~X- d-O CLL, <br /> <br />PROPERTY 0 PHONE #:~ f' (_ ~ f' J ( ().J-y <br /> <br />PEE OWNER: <br />ADDRESS: <br /> <br /> <br />APPLICANT'S INTEREST IN PROPERTY: <br /> <br />FEE OWNER <br />LEASE HOLDER <br /> <br />CONTRACT PURCHASER <br />X OPTION TO PURCHASE <br /> <br />DESCRIPTION OF REQUEST: j,C6- ,ad-- 0--<--- ~~ -\..:, ~<L <br />. <br />dC!l D-L "o..r<.J,l~ <br /> <br />. --- <br />REASJ::FORREQUEST: .~<--c:)-v- <br />J-u (v;"'-I /,)~rk <br />I <br /> <br />>&cc ~G 9 <br /> <br />T0 C~.-vJI["( <br /> <br />I. <br /> <br />By paying the above stated fee, I understand that no refunds will be issued in full or in part, at any time, <br />even if the outcome is denial. Q . <br /> <br />~~ fL,~~ <br />Signature of Applicant Signature of Property er <br /><:;) <br />7-/0 - e'f<~ <br />Date <br />