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Conditional Use Review Application (Cont'd), <br /> Page 2 <br /> 11. To whicb section f Art' le II the ly e C con itional a doe application apply. <br /> 12. The appllicaffntt agrees to1 23 pay the total costs of the review. <br /> NOTE: If insufficient space is provided for 1-12 above, attach your answers on a seperate piece of <br /> paper. <br /> NOTE: CONDITIONAL USE EXPIRES ONE YEAR AFTER APPROVAL <br /> UNLESS OPERATION HAS BEGUN. <br /> Attach all information requested to this application Corm. Attach any additional information you feel <br /> will assist in the evaluation of this request. <br /> PRINTED NAME OF APPLICANT <br /> SIGNATURE OF APPLICANT <br /> ADDRESS _C:r(2 <br /> gPHONNE ,245—CY 9 — <br /> '&E NON-REFUNDABLE FEE RECEIVED DATE ?'7'.-�ZC 1 <br /> SIGNATURE OF AUTHORIZED AGENT /12 �ll �.ldG�{c /0� <br /> J <br />