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Land Use Application <br />74 ' Iat - Sketch Plan <br />[ Plat - Preliminary Plat <br />❑ Plat - Final Plat <br />❑ Administrative Plat <br />Site Plan Review <br />❑ Easement/ROW Vacation <br />❑ Conditional Use Permit <br />❑ Interim Use Permit <br />n Comprehensive Plan Amendment <br />E Variance <br />Zoning Amendment <br />III Home Occupation Permit <br />Dwelling Moving Permit <br />❑ Environmental Permit <br />❑ Registered Land Survey <br />II Non -Traditional Animal License <br />❑ Beekeeping License <br />❑ Private Kennel License <br />Applicant Contact Information <br />Please note: All official communication will be routed through this contact. <br />Name: <br />'1m 0(0 (A)1- TiffiL LLe._. <br />Street Address: <br />7553 6u4)tt>o!/Q ma, c)I-7-F. Ji5- <br />City, State, ZIP: <br />124m5 t t 1 M A/i � <br />s-5 6 <br />Home Phone: <br />Work Phone: <br />go, 42.7 5'?55 <br />Email: 41641.r <br />p,D Fax Number: <br />l <br />«5 q, Z`� 4 L S <br />Name of Business (if <br />applicable): <br />ub[V i . 0/Mb : CDC <br />Business Address (if applicable) <br />Business City, State, ZIP <br />Business Phone: <br />Business Fax: <br />Subject Property Information <br />(Location of Application) <br />Address <br />tee r'i <br />PIN <br />Zq® 1--"' <br />5-14 <br />009I, <br />I ft it Q%0i® <br />-Z5-14"6 <br />Legal Description <br />Zoning District <br />Contact the Planning Division at 763-433-9824 or <br />nnin <br />co <br />to request a Zoning Verification <br />