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<br /> <br />-- <br /> <br />, ... <br /> <br />: j. " <br /> <br />C':"i OF OCSE'1I"'"--I.C: <br />2660 Ci"ne Cen"'".....er ~'ri.;e <br />!Os< rille, 2"'.ir~~ 551~ <br /> <br />Please d-..eck item or it.e:s for -..tridl yoo. a.."'2 a~lyi..""q: <br /> <br />RID <br />-- Rli'zonirq <br />'"7.TI Special Use Fen::it <br />- Vacation of Right-;:,f-Way <br />- Pre.lir.:inary an:l Firal Plat <br /> <br />$75r~ <br /> <br />O:.::r.:::re.~ensl.Ve Plan ;'..~t <br />Divisicn of Platted I...--Tt <br />= Ridoc:atian of I:'"wel.lirq <br />Vari3..'1Ce to Zr.:>nirg arm..'1anCe <br />- Shoreline Pemit <br /> <br />$300 <br />$20D <br />$200 <br />$500 <br /> <br />$750 <br />$100 <br />$10,) <br />$200 <br />$ SQ <br /> <br />Please CXl:;)let.e fol.n by typmj or print-..irq in ink. If tr.e spaces pro'I.-ided are <br />:1rJSUf'ficient, use aQditi::.nal ~.heetsr ~~ :iIlfccatian to the proper item =ur.Qer's: <br /> <br />1. <br /> <br />~a te\~ay De JP j a p:ne !It C0i'ipany <br />wane 01: 6.wner: ,F1.rSt:} <br /> <br />(IDc.::J..e ) <br /> <br />( SOS) 785-1330 <br />{.L3.StJ lH'.o."1e) <br /> <br />2. 1637 St. Ja"~es Stxe"t LaCt-osse <br />.l1dct..-ess of ().,TIer: ~Q. alrl ~"trt:oet) (:itYi <br /> <br />WI <br /> <br />(State) <br /> <br />Ed <br />3. <br />N<.Ime of ~licar,t: {Fi..""St~ (l':id:ilc) <br /> <br />He r~ge 1 <br />(I.ast) <br /> <br />WI <br />(State) <br /> <br />4. 163/ St. James Str~€t LaCrosse <br />~ of ;'.pplica.."1t: (No. ani Street) (c.it:y) <br /> <br />5. ~201 LarDenteu~ Avenue West <br />St...-eet l.dd...."'eSS c~ ::."">rcpert'l InVolved: <br /> <br />6. <br /> <br />Cc:plete ~l D;..scripti~n of I'I"::;:e.rt) Involved: <br /> <br />(See Su;"vey) <br /> <br />7. <br /> <br />Date l~...z-;_y Aa:r..u:7c:d: <br /> <br />~arH_h::t.y 15 ~ 198~i <br /> <br />8. <br /> <br />Pr--.:!Sei""1t :;se of Prcperty: ~~i\ i ~ 9. <br />F::q;c~'<:rl Us: :;f Prcpe.r'C',':_____ <br /> <br />Present :c:nL""'XJ of 1=-~.rt'!.: <br />Prc::.J-..""'S<:ri Z:;,;-.irr; cr Ptu;tny:____ <br /> <br />1 n. ~_~J1t LA"'Y:D!""e!:e!"'..5i\ -e Pl3...'1 ~iGr" .J.t.~.:::;: <br />?rc~-..eci l"'~~ET.sive Pl.:...') ~::"g:'.."'1t:.=::: <br /> <br />11.. ~..a'l: plan or c..~lS..? :-a\:e.s t~ req'~~ ~~~':t? <br /> <br />Additior: and r2!';odelinq o-f ex~stirlc t>unal.!."J" . <br /> <br />12. <br /> <br />\-.'h.J.t i.s t1':e e..~-x:c;-U:i ~ffl:'L.-t. or t.~Q f::~oj ~..:lr~e? <br />\Ta.lt:CS, ~~c...l~ ...~, satety, purl'~~, t~::::.c \::cm.l.t:.c.....s, etc..) <br /> <br />fr.....,... <br />\...~J... <br /> <br />e..'Q.::pla, on prcpe...'"'tj. <br /> <br />--~")i~L ------.. <br /> <br />----.--- <br /> <br />5J602 <br /> <br />(Zip) <br />(D.O. ) <br />(H~one) <br />54602 <br />(Zip~ <br /> <br />Sl <br /> <br />