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FROM CMOtAMOV 0 2010 10: 10/ST- 13S 12/No. 7620i3S106 P 'd <br />ega! description of land on which action is proposed: (attach legal description to the application). <br />Existing' ZGn ft District(s): <br />Number ofExisting LoES: <br />"NuniW_ - fPr9pood• Lots: <br />Num*,of ftoposed Dwelling Units: <br />Propos9d Axes e. Loi.$ize: . <br />if W variance request; reason for the <br />Is all or a portaon ofthe building site located in a potential floodplain or area <br />with slopes• in excess 'of twenty percent: na (yes or no) <br />. •- ' 4f Yek.:which of these conditions exist- <br />Value of proposed tjew construction: <br />Wiltthe -prooo$ed project kequirc any slate or federal permits: ves yes.Qr no) <br />I:f its, stale•whiCl : peff its:ot approvals we-required: Construction Material Liidied • Impact <br />(110): operation Reclamation Permit ate of Co ore o' <br />tf a H:3.`;104I'0er is required. for what matters of local concern and stale-inicrest: <br />Addjtional•perti .information: .: <br />• >3aeque9ft isbr a coed t one use permit to mine as process' gravel <br />& 410'IF1CATIUN •SY THE APPLICANT: <br />. I:h*by stale that.tiiis application is made with full knowledge of the, design stagdards, 4 <br />A. <br />ocedtpes?:pi,blz hearing and meeting requirettteras, decision criteria and.ot er; raNisi4nS.cgntaiited <br />in.the-okifer tmo Couno Land Dt 16, menl GO* and Cq <br />F applicable to this.applic?ion; <br />?.. ?..----- a ... ?. <br />Signature"of Applicant: <br />Date: <br />Ti=thy D illiama <br />6. ACTION ? <br />?• .. Betty .. illiame 1 . <br />Final approval'. conditional ppreval or denial by the authorized permitting authority:. <br />Q <br />0; 01? <br />Title <br />Date . _r <br />Page 288 <br />::- 1,r <br />- <br />z rr <br />i•