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l AppLICATION for ZONING VARIANCES and <br />SPECIAL EXEMPTION PERMITS <br />APPLICANT INFORMATION: <br />APPLICANT _..... ..... ..... <br />ADIDRESS __ _______________________ <br />.... ..... __�,_________��'____________________________ . <br />...... ..... ... ' R.;?ql <br />TELEPHONE <br />OWNER <br />ADORESS <br />TELEPHONE <br />GENERAL INFORMATION: <br />AREA of PROPERTY: <br />_ <br />CURRENT ZONING __ <br />CURRENT LANO U5E _ <br />SUMMARY of PRO O5EO USE <br />__°,- <br />: <br />APPLICANT <br />OWNER <br />� <br />F�E. c� <br />AMOUNT ASSESSEO - � 5O <br />AMOUNT PAID <br />ACRES of SOUARE FEET <br />PROPOSED ZONING <br />, <br />/ <br />DATE <br />Y.W.1921.1 ... .... .... <br />FOR STAFF USE ONLY PROPOSED ACTION: <br />ENCLOSURES: <br />APPLICANT'S LETTER <br />SITE PLAN <br />VICINITY MAP <br />IDATE OF PUBLICATION <br />AGENDA ITEM - <br />/ <br />� <br />3 <br />