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T <br /> "NOTICE OF INTENT" <br /> TO REQUEST A ZONING CHANGE <br /> • 'TOWN OF MONTROSE <br /> Name: ____ , C, --..a.......4 <br /> .i <br /> Address: 1� ; ,� �/ / � �elephone: (�0 y 76 <br /> ti <br /> 7 � <br /> 1. Purpose: -(b 70 d, C, / (off g _ <br /> 2. Legal Description of parcel in question: <br /> �,c 1 7S Ai SE <br /> 3. Attach map or sketch of parcel (professional, scale drawing not necessary) . <br /> Please show: <br /> (a) Road cuts <br /> (b) Dimension of land (including proposed division, if applicable) <br /> (c) Location of structures <br /> 4. Type of action requested: <br /> 41, <br /> oning request <br /> . Other <br /> 5. Miscellaneous information: ail...eti ZvwA.,t16214/4"S ..1--, / c ezzi , <br /> I (We) hereby acknowledge receipt of a copy of the Town's Land Use Plan, which <br /> is to be returned to the Town Clerk when action is complete. <br /> I (We) agree to proceed in accordance with the Town's ordinances and plans. <br /> Date: /) -- 17 - jj 7 Signed: (44,“"K`-714,- Da,,,,, <br /> Date filed: /4- /7- 2 clA,U,141., t/ _ <br /> IA Clerk <br /> Planning Committee Action: ' _ _ 0_141 01 <br /> Date: I/- 1?- 0P7 <br /> Town Board Action: ,/Qi iI4-t^ G Date: ///7—E7 <br />