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►. Specific Location/Rural Address Request <br /> (Entire Form To B Completely Filled Out Before Staff Can Respond to the Request) <br /> Today's Date 57/ C D <br /> Township/ Section of Needed Address /4 /,..4 <br /> 10K /Y2 <br /> Specific Area/Nearby Roads C T I Al `a' C-T/] ,X <br /> Parcel # OS1 '1 -32-1 - .�?`� O <br /> Person/Entity making this request Ill li e••■/ LI SC,A li P ki <br /> DANE . - 4 rmation for requestor G- 0) L 4 ak Q S ► G G <br /> COuNrY <br /> Peer 11. � � 3.x.3 <br /> MQY .! ? 2008 MACCk a 14/1 1h(A-a Si. GrCdvr.-cof, Co .-- <br /> Date of 0 ginal Request to this Agency(Date Stamp here) <br /> +'N. :,. ,r 4 Tptb� filled in sy Planning and Development Staff only) <br /> 6`y SON <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 /> 1icw s �� Cg 1z3 ► - OC Hwy 172A - 0Y <br /> 44 <br /> See, A <br /> 4.11 Z A,,,,jitfr <br /> Staff person taking in this request <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 />