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�� :, <br /> e: <br /> _ Poa it'ha 7 <br /> (i 671 Data c (.} r e.an _,•�'. <br /> co Derr <br /> Cc. r J <br /> A 'F'C Fhen.?n 'Pncre 42-g ?! - <br /> P` Fa" it ` Faz <br /> a .t Main � CO 18 Suzez • Centerville, Centerville, :nL 5538 <br /> 'EstablishedI8'57 (612) -3232 * `Fa.i 4298t29 <br /> CITY OF CENTERVILLE <br /> APPLICATION FOR PRELIMINARY PLAT - <br /> DATE PAID CI ) I I ICiJ FEE ,X7TCO <br /> STREET LOCATION OFiROPERTY }o 44 " A e <br /> LEGAL DESCRIPTION OF PROPERTY <br /> ")1otet, it- of -I-%ie. NE 67— e 12, <br /> 5P LC2 .1JA 1. gartav Z <br /> SIZE OF PARCEL (S) 0 1'S - <br /> PROPERTY O W N E R : Pc K< Au e ' u I; r e•S PHONE r 7Z - 4 0 3 <br /> FEE OWNER: h!l Z. i-ri e (A-L j —c S ; c i <br /> ADDRESS: (,7 q s ,g 4- v ;.s._ S-o • r ii'i - S 03 <br /> APPLICANT'S INTEREST IN PROPERTY: <br /> FEE OWNER CONTRACT PURCHASER - <br /> _ LEASE HOLDER OPTION TO PURCHASE <br /> DESCRIPTION OF REQ TEST: �� P 17 ✓�1 % bti t I to / eta ( /[ 0,4 n a� � t v✓ <br /> C e n „ !i 1(«. '- <br /> REASON FOR REQEST: <br /> '"o U c,z z P- A �f Ae-,,, <br /> v <br /> * Pfus any additional costs <br /> 'g rare of appi�t incurred fJr engineering, <br /> I C can , �2 legal fees. publication or <br /> Signature of prooenv owner other requirements. <br /> 5 J <br /> Date <br />