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<br />Jan 26 04 OB:53a
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<br />Kent
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<br />763-753-9357
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<br />r rom: THE MONTGlJ.fRY GROUP
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<br />651
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<br />Post~it~ Fax Note
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<br />7671 Da"
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<br />.-"'''' '.~_I CllYOFCENTERVILLE ,/,_..:,.:~_q...Il...(.. -,.,(;.
<br />APPLICATION FOR LOT SPLITILOT COMBINA TIO~~9>
<br />
<br />l\J\y additional co",," inaured for
<br />LOT SPLITILOT COMBINATION: FEE: lr;,O +' engineerins.leg.l r.... pubticaliOll or
<br />.ther ""lui:emenIB
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<br />REZONING:X-- DATE p~:
<br />STREETLOCATlON OFPROPERTY: --.f107J.O ~'! ,(rx ;(;
<br />LEGAL. DESCRIPTION OF PROPERTY:
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<br />SIZEOFPARCEL(S): f.">'( acMe-
<br />PROPERTY OWNER.: ~../.Clt. Oll/:.'r ,;,f..f'I/",vPHONE #: 76? -7;1- Y"',H> 6
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<br />FEE OWNER: .....,.~(.;(. 4ki N' 'Nft.(
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<br />ADDRESs: ~', ~" .J. "..... ".... ,IIJG. hA,hc."HI """''' S' .>D I '
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<br />APPLICANT'S INTEREST IN PROPERTY:
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<br />FEE OWNER
<br />LEASE HOLDER
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<br />7'-"
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<br />CONTRACT PURCHASER
<br />OPTION TO PURCHASE
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<br />DESCRIPTION OF REQUEST: 7.:, .t:f:'~~.~"r'
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<br />REASON FOR REQUEST: ---fr- "c.", (l' f,)(~'M A".", ,(r", 0( i:
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<br />By paying .lhe .00'" 5la1al fee, I UII_d lh.lllO refunds will be i
<br />even ifJl~1iulCOIlle'is deoial.
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<br />, Signature of Applicant '.
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<br />Rx 1ime:Ol/26/2004 08:45
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<br />Rlt No.: 1m P .nm
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