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SAV 80-09'04 10 4'As; a 4,q 11 n YII,,r: �1V: ADDRESS AMID LEGAL • IN, *' w• 1'1 • M:r• 7a+• M�1'� • •MMI ' � `1 �+� � • � • A. ZONING ACTION: ORDINANCE NO: B. SPECIAL USE M MIT (S) : C. IDT SPLIT(S): # D. VACATION (S) : #d -4 f ® 'D If ORDINANCE NO: " E. APPEALS OOMISSION: APPROVED DISAPPROVED • DATE NO. CITY OOUNCIL: APPROVED DISAPPROVED DATE NO. F. EASEMMUS: REQ'D DEPT RECD Bikeway/walkway Street right-of-way utility Drainage Alley Other (Specify) G. LICENSE S) (List): Date of Renewal: H. STIPULATIONS (List): DATE REQUIRED DATE OOMPI TED I. MISCELLANEOUS: