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APPLICATION INFORMATION <br /> • PT'N/C.U.P. # '9(:J TOWN p,G,E /e,p Sec. AO <br /> OWNER i.X I f ./SA/7Z -- -- ---— <br /> AGENT /'t1/Y6 P 141 7'� ]AC. Ctl/WAil b- di/RA-XS <br /> PARCEL ADDRESS (33 /miss-4004i /Z4'• <br /> PARCEL # /2-/O- 217, Z/9, ZZ4 ZZZ AREA 0' ACiZCS <br /> SUBDIVISION CSM # <br /> %CROPLAND PASTURE OTHER ,4/ ' &,eAV L �/r <br /> If From A-1 Agriculture (Exclusive) , How many acres remain in the A-1 Exclusive Zoning <br /> Lot? -Improvements are located on: Original Pc'l. Rezone/Pc'l. / , What percentage of <br /> improvements are located on rezone/C.U.P. Pc'l. <br /> SEWAGE DISPOSAL, PUBLIC PRIVATE / EXISTING <br /> NEW PMT.# WATER: - PUBLIC PRIVATE / <br /> ADJACENT LAND USES /- / l ( <br /> EXISTING ZONING /4 - Z, <br /> REQUEST IS FOR A-I rK <br /> * EXISTING USE /f'G Tel"; 7 P i S'7 <br /> * EXPLAIN PROPOSED USE y.9-s74-6eCZ C! / c-ch✓7;) <br /> DEVELOPMENT WILL START TOWN BOARD CONTACTED? YES NO <br /> ") ∎ DATE: , /fr 4P <br /> (Agent - Owner) �/ <br /> PT'N/CUP# 0763 <br /> #1620-69 (12/84) Z. PT'N/CUP INFO <br />