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APPLICATION FOR CONCEPT
DIVISION III ~
nb./
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 Appllcations: $25.00.
NAME ~F PROJECT: SC\ \P 3 M C\'¢>
NAME OF APPLICANT: M rjy h Cf- Rhtk!w R[j S C 6l.--__
Q
(Must bJ owner ofrecord) . ~/
SIGNATURE:
>
~(Must~
be owner ofrecord)
DATE: ,f;l.-R--/t'
MAIUNGADDRESS: 3037 Frt/;'r rU/'117 jJd @/!::;7P/j /?,(/~7;.
,
TELEPHONE NUMBER: _"l',.!...:-/~7_-:=d.::.::3~c9:----=::O::....:5=-:7_5 _
Representative Information
NAME OF REPRESENTATIVE: ,!?OXQ tJ IJ e !love-
"MAIUNG ADDRESS (rep.): 6035 Frw; /- ..Far/?} tPd
TELEPHONE NUMBER (rep.): .Lf/7 - 336- tf"<fOLS
Revised 12/19/03
Property Information
ACCESS TO PROPERTY (street # and name): -303.5 F /'v;- T / 0 / ' $ /(Y</
I/o lI>sr~ /, /1!d t 5';; 7 ~
)
Number of Acres (or sq. ft. of lot size): _--",,2J_D_--,·~-.:...::::.G _
PARCEL #: ('i-ted -~-Clc?c:J-tZl::5 ~ OtJ 1. cJo/
(P-mot II MUST on petmIt. I!luo........: 00-0.0-00-000-000-00o.000. ThIs number b on top left hand oo"",nt
~ tax ololbw t. It you haft lIot.,.1d tu.. on property, "'lid ..,,,,.. ""1Ile at ~ 0 _ of property.)
SECTION: ,3 3 TOWNSHIP: ci?c2 RANGE: -=d~./_ _
NAME OF SUBDIVISION (if applicable): ft(s;-c-1 Sti'.60?,/s">'o/'}
Lot # (If applicable) B,LOCK # _
WITHIN 600' FROM THIS PROPERTY IS:
(Check all land uses that apply)
o Commercial 0 Multi-Family M Residential .MAgricultural
o Multi-Use 0 Municipality
SEWAGE DISPOSAL SYSTEM:
o Treatment Plant O! Individual
o Central sewer: District # _
WATER SUPPLY SYSTEM:
o Community Well
(, [
~ Private Well l:?'" q re j
l i
o Central: District # _
DOES THE PROPERTY UE IN THE 100-YEAR FLOOD PLAIN? 0 Yes a No
o Residential o Multi-Family 0 Commercial fJ Industrial
. ~ Special Use o Other - Explain: _
Revised 12/19/03
Anyproposedproject that does not have a posted 9:L:L address must be identified
with a su,vey 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: Hake this description as
complete as possible as yourpublic notice will be based on the information
provIded here.)
c0,-R fW7"?p L-
Revised 12/19/03
I
Date of Application
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