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.pplicant Name <br />►pplicant <br />►ddress <br />tome Phone Number (71,3) L{017— 1949 <br />:mail Address 6LA h j e & Zi eg ,.2 , r� e t <br />Jame of Business (if applicable) <br />tusiness Address (if applicable) <br />tusiness Phone Number <br />Variance Application <br />Void - Exeirr-ea <br />Applicant/Contact Information <br />n en <br />Street address City State <br />1 `4 5 a 3 rower by- <br />1I w IA, <br />Co_c1 <br />Wa'k Phone Number (143) 41$ - I 73 <br />Fax Number ( <br />Business Fax Number <br />Proposed site (subject property) of Variance <br />►ddress <br />� 67) 3 130 wev5 (V r I <br />IN <br />3D/3 <br />,egal Description 9,0 <br />v t, l a t a <br />1LISo3 aw.ers V�9 <br />(circle one) <br />Soning <br />dame <br />address <br />Phone <br />Number <br />R-2 / R-3 / B-1 / B-2 / E-1 / E-2 / TC other <br />Street Address <br />>-11s.ey <br />Property Owner Contact Information <br />(if different from applicant's information) <br />Home phone number <br />( ) <br />City <br />Work phone number <br />( ) <br />1 of 2 <br />Updated: January 2004 <br />State <br />03 <br />Zip <br />.6'.6 303 <br />Zip <br />