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<br /> <br />tervi{{e <br /> <br />1880 'Main Street . CentervilIe, 'MJV 55038 <br /> <br />'Esta6(islied 1857 CITY OF CENTERVILLE (651) 429-3232 . Pcvc(651) 429-8629 <br />APPLICATION FOR LOT SPLITILOT COMBINATIONIREZONING <br /> <br />C" LOT S~IoIT~T COMBINATION: _ <br /> <br />STREET LOCATION OF PROPERTY: <br /> <br />Any additional costs incurred for <br />FEE: 7J1/J. 'J,' + engineering, legal fees, publication or <br />,/.J. other reqwrements <br />DATE PAID: ,:) -I tJ - 05 <br /> <br />7d l/ / /l1A 1M 6T/ <br /> <br />REZONING: <br /> <br />LEGAL DESCRIPTION OF PROPERTY: <br /> <br />SIZE OF PARCEL(S): <br /> <br />PROPERTY OWNER: 1((\ ~~ t- KI'I 1\1 ~ PHONE #: fa 5/ - 'I J9 - () 0 ~ 1 <br /> <br />FEEOWNER: _E6, At'll :301/ &/L-749-~?/tJ(&"0 <br />ADDRESS: Ju-~(\ MAJ. SSo.3 ~ ' <br /> <br />APPLICANT'S INTEREST IN PROPERTY: <br /> <br />'f- FEE OWNER <br />LEASE HOLDER <br /> <br />CONTRACT PURCHASER <br />OPTION TO PURCHASE <br /> <br />DESCRIPTION OF REQUEST: <br /> <br />REASON FOR REQUEST: <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 /> <br />[):;;:;rnc:~~ Q4 c: ~J~ <br /> <br />Signature of Applicant Signature of Property Owner <br /> <br />c:(-/tJ-l/J!f' <br /> <br />Date <br />