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SITE PLAN APPLICATION
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Date Application Received: I �` Application #:
Fees Received: ( L '� `� C Receipt #: '-f k _ ; Initials: _ 1
1. Project Title: TIC,- xef (-,, I -W6 & No 1fl CN
2. Project Description: (ly(.�y1� I�rp� iT101�
113 N1 IINuJS10-1 v.4 ZW3
3. Location of Property: KV -V ( �1YLL-r`"1`
(Street address) vJ I7��) \/l4 22 ba 3
4. Applicant/Designer: 6W(S J—W9241,ICy
Name: 6 ffk1S TO -V— f1rY Telephone: Sb?- q 54 So!/
Primary Point of Contact: C (Q L S ---FU-*- IN P f
Address: NO"I `13NPc1TW.W RD. 61A-&• Zo v
L -w t S v1 t,u1C- , l<`Y 14- Zd
5. Property Owner (if different than above):
email: CHV-lS�G� PF -314q/ PCG�StiVGC
Name: Tis j c*o Wxc Hu-o1w r- LLC Telephone: 5o?- Listi -6611
Address:: Gu iIN
LOvtsy tt,t,E, ):! `F 4°20.5
6. Property Information:
a. Property Identification Number:
b. Total acreage of the parcel to be developed
C. Total disturbed area of the parcel:
d. Present Use:
e. Proposed Use:
f. Magisterial District(s)
8
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