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none, Install satelite antenna, Application
• • ADDRESS: APPLICATION APPLYING FOR: (CIRCLE) SATELLITEnANTENNA/NONCOMMERCIAL RADIO ANTENNA PROJECT ADDRESS: II. I l P�9'1.-1-(k t CS12 ,) et- LEGAL DESCRIPTION: -1L ~ I4 PROPERTY OWNER: .J0-1N'\ GersN2t ADDRESS: 4 ( P � lA U/vra - TELEPHONE NUMBER: 377 `N1 AGENT/REPRESENTATIVE/CONTRACTOR: IJtAt_ bf� AtJlz-\Oks 6,( F(ZAQL 'Zo5p.q. d,z. 10-\ TELEPHONE NUMBER: 5`: 5c) t70 FOR STAFF USE APPLICATION RECEIVED: FIELD INSPECTIONS/CONDITIONS OF APPROVAL DATE CHECKED: 2'- 49v DATE CHECKED: SETBACKS VERIFIED DATE CHECKED: SCREENING/LANDSCAPING INSTALLED/PROVIDED DATE CHECKED: CITY ACTION APPROVED: DATE: RETURN FOR CORRECTIONS: DATE: RECHECK: DATE: BY: BY: BY: BY: kl