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-h :g;i:: VL D <br /> <br />DATE PAID //Z Z -~'? <br />~ ~OENED BY ~1~ ~ <br /> <br />LAND USE APPLICATION <br /> <br />· · PLANNED <br /> <br />GRADIN~ OR F~L/JNG <br /> <br />Name ef Appl~anlC,~n:Lper ~id~e, a ~a~;~:mer.h,.:L~3Phone # ,:~.3,? -5863 <br /> <br />Conta~.Peman: ,]'n~'~ Nflle~- <br />A~ldre~: ~140 ~e:r~'~.ce La.ac <br /> <br />Prapettylclentlfica:tlannumbar:. 7,_19 32 2~, ~ Q{;)0I , , . <br /> <br /> I under.md the fao for a va.,lance, ¢oncr~tonal u~ ~rm[ ~d ~ ~ ~d ar d~, ~ a ~ef~ <br /> · fee. I ~m ~ the ~~.~ ~ ~rm~ ~ ~1 ~ ~ ~ C~~ wh~h ~.~ t ~.~d ~ <br />"'. "t :: ::' ::.. ~ ~g~ lmm ~.~. ~ ~ ~ ~ubm~. <br /> <br />~pre,,.m~tive(sig~ure) .-,.. Dee <br /> <br />'Date <br /> <br /> <br />