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Land Use Application <br />Plat — Sketch Plan <br />I I Plat — Preliminary Plat <br />Plat — Final Plat <br />Administrative Plat <br />1 1 Site Plan Review <br />( ) Easement/ROW Vacation <br />Conditional Use Permit <br />Interim Use Permit <br />n Comprehensive Plan Amendment <br />Zoning Amendment <br />^ Home Occupation Permit <br />Variance <br />I J Dwelling Moving Permit <br />Environmental Permit <br />I I Registered Land Survey <br />Non -Traditional Animal License <br />Beekeeping License <br />I I Private Kennel License <br />Applicant Contact Information <br />Please note: All official communication will be routed through this contact. <br />Name: <br />Alain Antilt v1 <br />Street Address: <br />6700 We ciev. BI tic) <br />City, State, ZIP:OLG2_ <br />( Jv�� <br />Home Phone: .70 <br />7 y i 3--1 <br />Work Phone: <br />a�� �6 <br />C� t Avivict t1 6 (?)iTal <br />Email: R€r', <br />( 77 7(6ho f- a/'lj ( <br />Fax Number: <br />Name of Business (if <br />applicable): <br />'1L `7;_e_ ,e c[(YY\ (Jl UV C_t <br />di <br />Business Address (if applicable) <br />( ) tr7 1 c_u TO 1,0,e4+" (vl f-.,, <br />4 010 -: ( Q <br />Business City, State, ZIPkacqft.c,Q_Il <br />N „5-1-3 0 <br />Business Phone: 4 I a c/ S <br />Business Fax: <br />Subject Property Information <br />(Location of Application) <br />Address <br />PIN <br />Qg37uv iU <br />Legal Description <br />2=}() 5-30 <br />Zoning District <br />Contact the Planning Division at 763-433-9824 or planninq@ citvoframsev.com to request a Zoning Verification <br />18 Lf <br />