AC-2012-00234_0007.tif r=iling a' Receipt Number
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APPLICATION FOR ADMINISTRATIVE LOT LINE ADJUSTMENT
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1.
Scott D. Monzon and Terri D. Monzon 2065 Grant Street, Blair, NE' (402) 533 -4442
Applicant's Name Mailing Address Phone Number
(402) 426 -9626
2. Nile K. Johnson, Johnson & Mock, 1904 South St., Ste 101, Blair, NE 68008 j
Agent's Name Mailing Address Phone Number
(402) 533 -4442
3, Scott D. Monzon and Terri D. Monzon, 2065 Grant Street, Blair, NE 68008
Owner's Name Mailing Address Phone Number
4.
See atta
Address and Legal Description of Location - Subject Property
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5. Present Zoning District:
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g The parties agree that the care of the property.to be transferred from Mr. Thomas
State briefly your reasons for request
Soleva Niel is easier by Mr. Monzon, because of the location of the tree line
in Mr. Nielsen's backyard.
MONZON THOMAS SOLE VAD NIELSEN
Signatur of Owners) Date Signature of Owner(s) Date
DO NOT WRITE BELOW THIS LINE
ADMINISTRATIVE LOT LINE ADJUSTMENT APPROVAL:
[�v�ai icy rr. Lo i E i �I�y fA 11 iir 1 SL alor
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DATE SENT TO COUNTY CLERK:
DATE RETURNED AND MAILED TO PROPERTY OWNERIAPPLICANT: