APPLICATION FOR CONCEPT-
DIVISION III
TANEY COUNTY PLANNING COMMISSION
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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.
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NAME OF
AP PLiCANT :-.-h&J.fL!....l..41~::!:!::r.::-_~de~-L----!=:~'::t=LJ'=ir'6......",..----.
SIGNATURE........L+~~+=---..,~~~f-_ _
DATE: 07-;2.3-{)
(must be owner ofrecord)
-1.. "2i>
MAILING SUIIC- "-
ADDRESS: :2 q 2-5 Wefif 8eJ)ubD~ Rd fN\nJi~/t 110. 4- 5 g'tJ 7
I V
TELEPHONE
NUMBER: 4J7-~/p/-51e?<6
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MAILING ADDRESS (rep.): roo s-klr ~ 2l/'l 8u:ldt'1lf 4 SLl:le 1J &W5<JI7, fYJo, 67 "'it,. ~
TELEPHONE NUMBER (rep.): 417- 3 3¥-8f20
ACCESS TO PROPER1Y (street # and name): Go r-f C / u.b ~ r,'vt.
# of Acres (or sq. ft. of lot size): 5. /7
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PARCEL # J7-'fl. 0 -:n-{)M-OOO-~o'l. ~OD 17-<;{.O-3l/-oc()-OM-OO 1,00 ()
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SECTION: ~J.I '2 q TOWNSHIP: ?- 7- RANGE: ;2.../
NAME OF SUBDIVISION (if applicable):
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Lot # (if applicable) BLOCK #
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WITHIN 600' FROM THIS PROPERTY IS: (check all land uses that apply)
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COMMERCIAL MULTI-FAMILY RESIDENTIAL
AGRICULTURAL V MULTI-USE MUNICIPALITY
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TYPE OF SEWAGE DISPOSAL SYSTEM:
CENTRAL TREATMENT PLANT / INDIVIDUAL
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PUBLIC WATER SUPPLY SYSTEM:
CENTRAL COMMUNITY WELL / PRIVATE WELL
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DOES THE PROPERTY LIE IN THE 100 YEAR FLOOD PLAIN?(Circie one) /'
YES_NO_Y_
THIS REOUEST FALLS INTO ONE OR MORE OF THE FOLLOWING CATEGORIES:
RESIDENTIAL MULTI-FAMILY COMMERCIAL INDUSTRIAL
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SPECIAL-USE OTHER
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Please give a description of your proposed project including all uses:
(IMPORTANT: Make this description as complete as possible as your
public notice will be based on the information provided here.)
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