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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��t &y 9 2 OO <br /> Township/ Section of Needed Address roS,S- Sec. 0V 4- l q <br /> Specific Area/Nearby Roads f2 K o a/ <br /> Parcel# 0;0/0707- / L/� - 9D 0 <br /> Person/Entity making this request niAeL Esser <br /> Contact Information for requestor 5 ( . 12, via p�. <br /> 144. 1/ofeL w s ' 57 <br /> og-7 (00 <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. <br /> (Include any specific request or suggestion that may be important to Staff who are working on the Assignment of the Rural Address) <br /> Staff person taking in this request -4 <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 />