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c) E-- 23 2 <br /> Specific Location/Rural Address Request <br /> (Entire F rm To Be Co pletely Filled Out Before Staff Can Respond to the Request) <br /> /I ZO /OE <br /> Today's Date 5_ <br /> Township / Section of Needed Address y0 r K a <br /> Specific Area/Nearby Roads S k1 y,- ,s y6,_ /` V A k sc �` `/ US 0 / 1 <br /> Parcel # D7 VO 1 / 2- " 0C3 —S2lo D <br /> Person/Entity making this request Te c S t C G C r o j s C <br /> y . <br /> Contact Information for requestor -- / 9 Pd ✓ e; it' '' Pt <br /> ,SSCjri,SSC �' y4 , , C v <br /> Cci y , 6- ,, ,e 1,/v C3 :5 2 ) <br /> Date of Original Request to thi- gefcy(Date`Sramp her ) <br /> (To be filled in by Planning and Development:.taff only) <br /> N 0 V 2-6 '1,:-,'.2 <br /> Short Narrative of what you •w about this situation, d any collateral information that <br /> you have obtained in this matt:r1 , , .-, . <br /> (Include any specific request or suggestion th e t maYlie''ihlportant to Staffwh'oATejworking on the Assignment of the Rural Address) <br /> A1( ‘„) EP L 0t- 2CcT i i 2 73 <br /> Al hi <br /> cit__ 0 tr stre.-- VI-- 4 y <br /> 5 I I R f (94 <br /> / l_ Z CS 11, 2. 2- ) 3 <br /> Cc <br /> ,� V�v- o <br /> / <br /> 1 g 141 <br /> 5 j p104 e,, A irr L,c t/ <br /> C- <br /> Staff person taking request in this uest / C•Requestor shall for provide a site plan, drawn to a measurable scale, including lot lines & <br /> lot dimensions, and any existing or planned 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 />