P&Z Application for Concept for CJS Remark Inc

TANEY COUNTY PLANNING COMMISSION
P. O. Box 383 • Forsyth, Missollri 65653
Pbolle: 417546-7225/7226 • Fax: 417 546-6861
eJnnil:grc/p-@co.tnuc'y.mo.us • lVebJiu: JVJVlv.tancycounty.org

APPLICATION FOR CONCEPT
DIVISION III
TANEY COUNTY PLANNING COMMISSION

The Concept Application is for the use of the Planning Staff and Commission to
enable us to know the nature of the planned project. The official Division III
Application for permit will be filed along with everything needed to complete
your file, as listed on the Division III Procedure Checklist. Division III
Applications: $100.00, Special Use Applications: $25.00.

NAME OF PROJECT: _-""C~:I..L...:::S=---'....:1?-=£.....:../_Vl_f}.....:..1<_JC--=--_/_At/_C=---..:..... _

NAME OF APPLICANT: 7J!JV JD L U 525 Y
(Must be owner ofrecord)

SIGNATURE: E~~? (Must be owner of -ecord)
DATE: 11-3- o~

MAILING ADDRESS: ;;2. / ij £. PRle.-& ~T. BRtJ-N£O/I/Jo. ~5'r:,lb
TELEPHONE NUMBER: _ _Jj_/~7-=-;J-:........::..3_0_-;J..=---g_3_tf~ _

Representative Information
NAME OF REPRESENTATIVE: _

MAILING ADDRESS (rep.): _

TELEPHONE NUMBER (rep.): _

Revised 12/19/03
 Property Information

ACCESS TO PROPERTY (street # and name): /9&0 s7l9/~ Hwy \IV
'$P()lV~K:5Ir£. M6> f.t 57 3 /

Number of Acres (or sq. ft. of lot size): _----'-/.!<..;)....L)_Lf._~_(}____"'5:o,,:&'_'_.!-r-!.:J:!..-- _
PARCEL #: 09-3.0-08 -«)iI-OJ" -009. 00/
(Parcel # MUST be on permit. Example: 00-0.0-OO-OOO-OOO-OOO.000. This number is on top left hand co""","of
property tax statement. If you have not paid taxes on property, must have name of previous owner of property.)

SECTION: --=O...:::.8 TOWNSHIP: --"'.J--=3=---_ _ RANGE: ;;..0

NAME OF SUBDIVISION (if applicable): _

Lot # (if applicable) 10 rll '3 <l-NS' LT9 BLOCK # _...:.../...:::;h _

WITHIN 600' FROM THIS PROPERTY IS:
(Check all land uses that apply)

,MCommercial 0 Multi-Family B!.Residential )(Agricultural
o Multi-Use 0 Municipality

SEWAGE DISPOSAL SYSTEM: .
o Treatment Plant 01ndividual
o Central Sewer: District # _

WATER SUPPLY SYSTEM:
o Community Well 0 Private Well
~ Central: District # ....:;:;l _

DOES THE PROPERTY LIE IN THE 100-YEAR FLOOD PLAIN? 0 Yes ~ No

THIS REQUEST FALLS INTO ONE OR MORE OF THE FOLLOWING
CATEGORIES:

o Residential o Multi-Family )(Commercial 0 Industrial
o Special Use o Other - Explain: _

Revised 12/19/03
 Anyproposedproject that does not have a posted 911 address must be identified
with a suniey flag at the proposed access to the property. Failure to post the
survey flag will result in a delay ofthe Public Hearing. Please give a description of
your proposedproject including all uses: (IMPORTANT: Make this description as
complete as possible as your public notice will be based on the information
provided here.)

/11£ I/PJti c;9-!J/V !-VJZ? BG'C t9JVJE:. cpp;:;:/c:~ FoR:.-

2£/V7&JZK me OrrJc:E- vllll.-- BE v5EP Fa:e
ClIfTGJY)$l? 12,[;2#77<:9#5 /75 WE-a- 4-~ jV'vY9-.J<PYb:. ~j2T­

.woRK 9:: 5C?&G-NS £t?!2 ?/2/J'Y77At::. III.£- J.-(JR?E-
'!3IJ/iPINC- 3EH/flO 7Hfi·CJt13/N WILL· lJ£. v<;£;D
;t? IIt?I6& PJ2aOI.ICT ;:'O/Z. Pf(.J.NTl.Al;( df/£) T/-IE-

Revised 12/19/03

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