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<br /> <br />RECEIVED <br />SEP 1 0 200~ <br /> <br />-tervi[[e <br /> <br />1880 '!vfain5treet _ Centerviffe, '!vi1\[ 55038 <br />(651) 429-3232 _ 'fa:t (651) 429-8629 <br /> <br />'Esta6(ishea 1857 CITY OF CENTERVILLE <br />APPUCA TION FOR LOT SPLIT/LOT COMBINA TIONIREZONING <br /> <br />STREET LOCATION OF PROPERTY: <br /> <br />(JO Any additional costs incurred for <br />FEE: /~ + engineering, legal fees, publication orC ' <br />other reqwrements # . b ,'>' UJ, <br />DATE PAID: o/;oM &. /I~6f ~ <br />I 1.4. r <br /> <br />dO+..!:, aile.. So, L-zI-.3h0-.3;(-MO.L <br /> <br />LOT SPLIT/LOT COMBINATION: -X- <br />REZONING: <br /> <br />LEGAL DESCRIPTION OF PROPERTY: - ?o..-r o~ .<:;\J '/4 o~ SE '/~ o!;- <br />~nc d:3 'Vl~'l Eosr c:S c.... ~s<l <br />"'TI-tuTL LL~ y..~r o~ Nl:'/<t o~ SEII~ (jr;;,. 5=.23 ~""T o~ c....US<{ a,il,l <br />7......,.."s;. w\lll14 o~ 51.) '1-. .-C- ""=-~'\ <br />SIZEOFPARCEL(S): .0;1. {,Le... n.-.:>A- ;)0 Cl-C-, <br /> <br />PHONE#:&f'r (s'J /0;29 <br /> <br /> <br />FEE OWNER: <br />ADDRESS: <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: _t>.~~ .ad-. 0-"- ~"rc:..a.},,\' -\-.:, ~<.L <br />de, 0-<-. \>O-~\. <br /> <br />- <br />1:s.2N FOR REQUEST: {~cJ-v' <br />Ai (v:'A.--1 /.J/Ltrlc <br />I <br /> <br />ace --€. c; i; <br /> <br />7U C~.J-yV,II/'"( <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 />ev;&;~ O--c;- <br /> <br />Signature of Applicant Signature OfPrOP~ <br /> <br />7"-/0 - Of/ <br />Date <br />