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- <br />' h <br /> Town of, APPLICATION <br /> Q211; <br /> PLAN 'y 4": <br /> _ Appiiration Number <br /> REVIEW <br /> �-•.� • .,� CheCked by <br /> t8 <br /> • ,;:�Applican Day Phone <br /> NJ <br /> .,Applicant s Address 101, <br /> .5I(EVIA-1 c� ek 2.2- �6Representative�tf any} Day Phone <br /> Representative's Address <br /> �- <br /> Property Owner(l1 other than applicants In l� �a Day Phone <br /> Owner's Address 0 b <br /> Please indicate if all correspondence 1s to be sent to _7] the applicant the representative belohe property owner. <br /> What do you want to do?9 <br /> final our �What�s Y oal �A41 <br /> , <br /> Project Address 4--tV01--p— <br /> Name of tract,development or business In Me <br /> �- I eC4 <br /> Legal Description: Lot �C Block Tract AlY. t2-4e5r1r <br /> `Assessor's Parcel Number Present Zone/G.P.Designation — <br /> APPLICANTlREPRESENTATIVE: I have reviewed this com. PROPERTY OWNER/AUTHORIZED AGENT: l have read this <br /> pieted application and the attached material. The information pro• completed a plication and consent to its filing. <br /> "'vided is accurate. I understand the city might not approve what I'm <br /> applyin o , i s t c nditions of approval. <br /> St a Date Signed Date <br /> Y <br /> Received by Date Receipt Na <br /> Permit approved by Date <br /> Comments <br /> i <br /> •ti <br /> 1 <br /> 3 <br /> i <br /> i <br /> I <br /> • <br /> F <br /> 1 <br /> i•i <br /> i <br /> • <br />