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FOA OF,ICI US <br /> CD1LY � <br /> Conditional Permit ITo. � Date Hearing Adver:izod 1 7 <br /> Land Use Ayplicatic No,Fee <br /> Date r^�e�e�y �Q� i):te <br /> Aotice Posted 'l� '!�T Property Owners Notified & 4 <br /> APPLICATION <br /> COUNTY OF BURMTT LCTIITG COlIiITT+ <br /> C(I) (11e) yS! ZX VN Syox 5 <br /> f �o %G ,{ sc �5q <br /> Nane _ l Nailing Address <br /> hereby malce application to the Zoning Committee for a conditional permit for the <br /> following: <br /> ?a nt+ -L <br /> IV, r-rl. S�tCiC etc %.aKe ,2ld <br /> on the following described property: v7� 7`wo l2 a <br /> L.o-Tfe of eQei. FCea 1^Ap ,uoik..eA_ 1 p: �e BUY Gaverrne/�� <br /> Locatiof sec-+ a i. 2 + k[ N (Zc%A&g P 1S L,13 s# R,j_r nets Co k.ti•4 lP <br /> Lot Size Present Use �� Zoning District <br /> Present improvements upon land <br /> Proposed Use V, G n% n fn a <br /> List names and addresses of adjoining property oim rs: <br /> � , , �.� tUk rX m� 55 3 p <br /> 512.6 <br /> Signature of applicant Date Is' I 7 _ <br /> Action taken by Zoning Committee ;( <br /> Notes: <br /> Signed _ <br /> Secretarv. Count-; Zoniniz Commdttee <br />