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Specific Locaion/Rural Address Request <br /> (Entir Form TnBe Completely,Filled Out Before Staff Can Respond to the Request) <br /> Today's Date S <br /> \J I <br /> Township/ Section of Needed Address /'4-(' <br /> Specific Area/Nearby Roads ri-'SSL.7P <br /> Parcel # 9 SS ( r( X10 0 3 <br /> Person/Entity making this request , 4(', ,_L L-{ Inc W i-'v' <br /> Contact Information for requestor ' S ( —C't S C. <br /> Date of Original Request to this Agency (Date Stamp here) <br /> (To be filled in by Planning and Development Staff only) <br /> Short Narrative of what you know about this situation, and any collateral information that <br /> you have obtained in this matter. p/-e w {.•Dv e <br /> (Include any specific request or suggestion that may important to Staff who w <br /> be working on the Assignment of the Rural Address) <br /> -7 6G S.01J---ik. -(l"yv"\ 1) , A .` �F CgJV�✓" C.) C ),) ,. <br /> S----31- / 4 ,---)-- (4„) ____,„_ ,____ <br /> 4 __,, -,i., - <br /> -, iM* SL-/ -7- <br /> 'II <br /> Staff person taking in this request -.a n/v..5 <br /> Requestor shall for provide a site plan drawn to a measurable scale, including lot lines & <br /> lot dimensions, and any existing or pl <br /> rin <br /> ed ingress/egress to the property, and the <br /> distance from the lot lines to the ingress. <br /> Filed by Town & Section <br /> Form 2006- A 10-10-06 <br />