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<br /> <br />OOD} <br />"Z"ZI- <br />//")- <br />tV' <br /> <br />tervi{{e <br /> <br />RECEIVED <br />SEP 0 2 2DD~ <br /> <br />'Estab{ished 1857 CITY OF CENTERVILLE <br />APPUCA TION FOR LOT SPLIT/LOT COMBINATIONIREZONING <br /> <br />1880 'J.,{ain Street . Centervi{{e, 'kf'i'{ 55038 <br />(651) 429-3232 . 'Fa;r:. (651) 429-8629 <br /> <br />LOT SPLITILOT COMBINATION: <br /> <br />Any additional costs incmred for <br />FEE: W.4-IV.sD+ engineering, legal fees, publication or <br />other requirements <br /> <br />REZONING: ~o ~2 ,/ /J /. DATE PAID: <br />tLJrYcef; /-fCY.??<-n. bror <br />STREET LOCATION OF PROPERTY: c:,'7/~ t!erJ&rv;/Ie- <br /> <br />^-!A- <br />~"-~ <br /> <br />LEGAL DESCRIPTION OF PROPERTY: <br /> <br />SIZE OF PARCEL(S): <br /> <br />PROPERTY OWNER:~OI(/L1 <br /> <br />FEE OWNER: <br />ADDRESS: <br /> <br />APPLICANT'S INTEREST IN PROPERTY: <br /> <br />L- FEE OWNER <br />LEASE HOLDER <br /> <br />}:VA/US PHONE#: ~'5I-4;;fo-;).d!'; {h'",,,,.J <br />tWi7 - .{3t> -':>4>5"7 (tUN)') <br /> <br />J, 3. -? //r./r:.":. 'l <br /> <br />CONTRACT PURCHASER <br />OPTION TO PURCHASE <br /> <br />DESCRIPTION OF REQUEST: <br />,W<!'. <br /> <br />!l,y/ec-f <br /> <br />7017<../19 <br />V <br /> <br />LrJ IJr.e,opfA-b;'" 4' v <br />, . <br /> <br />REASON FOR REQUEST: r;]e.-e- /1kVe/ <br /> <br /> <br />in full or in part, at any time, <br /> <br />By paying the above stated fee, I tmderstand that no refunds will be . <br />even if the outcome is denial_ <br /> <br />Signature of Applicant <br /> <br />X 9-:1 -of <br />Date <br />