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Specific Location/Rural Address Request <br /> (Entire Form To Be Completely Filled Out Before Staff Can Respond to the Request) <br /> Today's Date 914S <br /> Township/ Section of Needed Address f'l/�i / i 1 T r\ ft( <br /> Specific Area/Nearby Roads ci( n4 (2e1 • <br /> Parcel# 0-7,e, _o <br /> Person/Entity making this request w t n 6M W-S <br /> Contact Information for requestor <br /> •r .44 _, COr <br /> nO .o (J S 3-7 ( L <br /> Date of Original Request to this Agency(Date Stamp here) <br /> (To be filled in by Planning and Development Staff only) ` l �� <br /> Short Narrative of what you know about this situation, and any collateral information that <br /> you have obtained in this matter. <br /> (Include any specific request or suggestion that may be important to Staff who are working on the Assignment of the Rural Address) <br /> 1�5 <br /> DAio uCGel o t-C3V1k atZilt 1,\A„c, <br /> 66,tilk/A/0 V <br /> Staff person taking in this request lap31(k. <br /> 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 />